Individual
MR. EARLEE ALFONSO SALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, PT
Contact information
Practice address
615 VONDERBURG DR, BRANDON, FL 33511-5972
(813) 654-1856
Mailing address
PO BOX 1516, DADE CITY, FL 33526-1516
(813) 841-2599
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT3692
LICENSE NUMBER
FL
Enumeration date
08/29/2007
Last updated
08/29/2007
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