Individual provider Active NPI

Joseph Salaz, M.D.

  • Family Medicine Physician
  • Ft Myers, FL
National Provider Identifier
1477540920
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0051735 Issued in FL
Practice address
5225 Clayton CT
Ft Myers, FL 33907-2117
Phone
(239) 343-8240
Fax
(239) 343-8241
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0051735 FL Primary

Addresses

Primary practice location

5225 Clayton CT
Ft Myers, FL 33907-2117

Mailing address

PO Box 2147
Ft Myers, FL 33902-2147
Phone (239) 343-8240

Other identifiers 1

IdentifierTypeStateIssuer
048806200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0051735FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System Family Medicine Current Accepting new patients

Locations

5225 Clayton Ct
Fort Myers, FL 33907
Phone (239) 343-8240

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1477540920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-8240",
            "fax_number": "239-343-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CLAYTON CT",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339072117",
            "telephone_number": "239-343-8240",
            "fax_number": "239-343-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZ",
        "first_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0051735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048806200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.