MEDICARE: MARY SALVAGGIO RN

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	163W00000X	Registered Nurse	RN9636695	FL

General Provider Information

NPI Number	:	1801738851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY SALVAGGIO RN

Provider Business Mailing Address
First Line	:	486 CLOISTERBANE DR
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-8232
Country	:	US
Telephone Number	:	901-237-7680
Fax Number	:

Provider Business Practice Location Address
First Line	:	486 CLOISTERBANE DR
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-8232
Country	:	US
Telephone Number	:	901-237-7680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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