Healthcare Provider Details

I. General information

NPI: 1407577257
Provider Name (Legal Business Name): ELIANA SALIBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W 1ST ST
JACKSONVILLE FL
32254-2085
US

IV. Provider business mailing address

7735 WATERMARK LN
JACKSONVILLE FL
32256-4111
US

V. Phone/Fax

Practice location:
  • Phone: 904-638-0355
  • Fax:
Mailing address:
  • Phone: 904-864-7274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: