MEDICARE: JAN J SALINA M.D. P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0080147	FL

General Provider Information

NPI Number	:	1245373018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAN J SALINA M.D. P.A.

Provider Business Mailing Address
First Line	:	4212 W 16TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7629
Country	:	US
Telephone Number	:	305-629-2669
Fax Number	:	305-981-2095

Provider Business Practice Location Address
First Line	:	4212 W 16TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7629
Country	:	US
Telephone Number	:	305-629-2669
Fax Number	:	305-981-2095

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUAN J SALINA
Credential	:	M.D.
Telephone Number	:	305-629-2669

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	08/22/2020

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