Provider Demographics
NPI:1134246093
Name:SALEM, RONALD B (RPH)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:B
Last Name:SALEM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 BUCKSKIN TRL E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-9727
Mailing Address - Country:US
Mailing Address - Phone:904-744-6895
Mailing Address - Fax:904-744-3858
Practice Address - Street 1:3935 BUCKSKIN TRL E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-9727
Practice Address - Country:US
Practice Address - Phone:904-744-6895
Practice Address - Fax:904-744-3858
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU 25281835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy