Provider Demographics
NPI:1043766983
Name:FELICIANO SALVA, KARLA JENISSE (MD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:JENISSE
Last Name:FELICIANO SALVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 365067
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-754-0101
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 4684
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-9309
Practice Address - Country:US
Practice Address - Phone:787-214-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR022043207R00000X
PR22043207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22043OtherMEDICAL LIC
PR22043OtherMEDICAL LIC