Provider Demographics
NPI:1093701005
Name:SALINAS, JULIAN A (PHD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:A
Last Name:SALINAS
Suffix:
Gender:M
Credentials:PHD
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 6512
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550
Mailing Address - Country:US
Mailing Address - Phone:850-496-5689
Mailing Address - Fax:850-267-3081
Practice Address - Street 1:1593 S COUNTY HIGHWAY 393
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-4218
Practice Address - Country:US
Practice Address - Phone:850-267-3088
Practice Address - Fax:850-267-3081
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6703103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75012OtherBCBS
FL766993300Medicaid
FL766993300Medicaid