Healthcare Provider Details

I. General information

NPI: 1962184473
Provider Name (Legal Business Name): JANICE SALCEDO MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4648 E COUNTY ROAD 540A
LAKELAND FL
33813-4472
US

IV. Provider business mailing address

3416 HERRON DR
MELISSA TX
75454-0319
US

V. Phone/Fax

Practice location:
  • Phone: 863-213-0365
  • Fax:
Mailing address:
  • Phone: 516-761-4431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1130402
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11047675
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: