Provider Demographics
NPI:1538154398
Name:SALLENT, JORGE ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ANTONIO
Last Name:SALLENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:500 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3598
Mailing Address - Country:US
Mailing Address - Phone:561-863-0105
Mailing Address - Fax:561-863-6779
Practice Address - Street 1:500 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33403-3598
Practice Address - Country:US
Practice Address - Phone:561-863-0105
Practice Address - Fax:561-863-6779
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL00389602080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP2268946OtherOXFORD HEALTH
FL0038960OtherME
FL14293OtherHEALTHEASE
FL203191OtherAVMED
FL14293OtherSTAYWELL
FL4251630OtherAETNA PPO
FL47453OtherBLUE CROSS BLUE SHIELD
FL204946OtherAMERIGROUP
FL3969385005OtherCIGNA
FL28937OtherSOUTHCARE
FL45055OtherNEIGHBORHOOD HEALTH
FL0038960OtherLICENSE
FL065871500Medicaid
FL2013841OtherAETNA HMO
FL2516164OtherAETNA
FL2516164OtherAETNA
FL2013841OtherAETNA HMO