Provider Demographics
NPI:1407087620
Name:SALIB, MARINA Y (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:Y
Last Name:SALIB
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N ORLANDO AVE
Mailing Address - Street 2:SUITE NUMBER 157
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7313
Mailing Address - Country:US
Mailing Address - Phone:407-539-0034
Mailing Address - Fax:407-343-0195
Practice Address - Street 1:501 N ORLANDO AVE
Practice Address - Street 2:SUITE NUMBER 157
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7313
Practice Address - Country:US
Practice Address - Phone:407-539-0034
Practice Address - Fax:407-343-0195
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL55239225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist