Provider Demographics
NPI:1245373018
Name:JAN J SALINA M.D. P.A.
Entity type:Organization
Organization Name:JAN J SALINA M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-629-2669
Mailing Address - Street 1:4212 W 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7629
Mailing Address - Country:US
Mailing Address - Phone:305-629-2669
Mailing Address - Fax:305-981-2095
Practice Address - Street 1:4212 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7629
Practice Address - Country:US
Practice Address - Phone:305-629-2669
Practice Address - Fax:305-981-2095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0080147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4148Medicare ID - Type Unspecified
FLH16302Medicare UPIN