MEDICARE: DR. STEPHANIE ANN SALAS MD

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	208M00000X	Hospitalist Physician	18156	NV
2	207R00000X	Internal Medicine Physician	18156	NV
3	208M00000X	Hospitalist Physician	27943	WV
4	208M00000X	Hospitalist Physician	ME136340	FL
5	207R00000X	Internal Medicine Physician	ME136340	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154332765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE ANN SALAS MD

Provider Business Mailing Address
First Line	:	9612 CLIFF VIEW WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-0238
Country	:	US
Telephone Number	:	702-701-7094
Fax Number	:

Provider Business Practice Location Address
First Line	:	13241 BARTRAM PARK BLVD UNIT 809
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5216
Country	:	US
Telephone Number	:	904-723-4827
Fax Number	:	904-747-1633

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	05/13/2024

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Directions to “ DR. STEPHANIE ANN SALAS MD” Practice Location

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