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General NPI Number Information
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NPI Number | 1154332765
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Entity Type | Individual
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Provider Name | STEPHANIE ANN SALAS MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 809
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5216
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Country | US
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Telephone | 904-723-4827
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Fax | 904-747-1633
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Provider Business Mailing Address
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Address Line | 9612 CLIFF VIEW WAY
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City | LAS VEGAS
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State | NV
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Zip | 89117-0238
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Country | US
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Telephone | 702-701-7094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 18156
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 18156
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 27943
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME136340
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME136340
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License Number State | FL
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