Provider Demographics
NPI:1235734534
Name:SALSBURG, GINA P
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:P
Last Name:SALSBURG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 MCCORMICK RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-1839
Mailing Address - Country:US
Mailing Address - Phone:904-642-7460
Mailing Address - Fax:904-998-9732
Practice Address - Street 1:11900 MCCORMICK RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-1839
Practice Address - Country:US
Practice Address - Phone:904-642-7460
Practice Address - Fax:904-998-9732
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0022713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist