MEDICARE: MR. REDNER JAVIER SALONGA

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1134461007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. REDNER JAVIER SALONGA

Provider Business Mailing Address
First Line	:	9745 TOUCHTON RD UNIT 303
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-4490
Country	:	US
Telephone Number	:	904-571-5289
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 BEACH BLVD
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3445
Country	:	US
Telephone Number	:	904-372-9082
Fax Number	:

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

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	09/18/2024

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Directions to “ MR. REDNER JAVIER SALONGA ” Practice Location

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