Provider Demographics
NPI:1518978592
Name:ARMENIA, SALVATORE J (PA)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:J
Last Name:ARMENIA
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:3003 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:MEDICAL ARTS BUILING 2ND FLOOR
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-875-8988
Mailing Address - Fax:813-876-9827
Practice Address - Street 1:6006 49TH ST N
Practice Address - Street 2:SUITE 310
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2148
Practice Address - Country:US
Practice Address - Phone:727-490-5044
Practice Address - Fax:727-490-5043
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-11-30
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Provider Licenses
StateLicense IDTaxonomies
FLPA2400363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL174750OtherWELLCARE
FL12159OtherUNIVERSAL
FL2122308OtherHUMANA
FLE0655YMedicare PIN
FL2122308OtherHUMANA