Provider Demographics
NPI:1902057243
Name:SALERNO, PETER JOHN (DO)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:JOHN
Last Name:SALERNO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11011 SHERIDAN ST STE 302
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1532
Mailing Address - Country:US
Mailing Address - Phone:544-371-1500
Mailing Address - Fax:954-437-0136
Practice Address - Street 1:11011 SHERIDAN ST STE 302
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-1532
Practice Address - Country:US
Practice Address - Phone:544-371-1500
Practice Address - Fax:954-437-0136
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 11079207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine