MEDICARE: DR. MARK W SALTA O.D.

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	152W00000X	Optometrist	OPC2252	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295737989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK W SALTA O.D.

Provider Business Mailing Address
First Line	:	1950 OLD GALLOWS RD STE 520
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3970
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 66TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-5504
Country	:	US
Telephone Number	:	727-381-3937
Fax Number	:

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	03/10/2022

Similar Medicare Providers

1497805535 — TB EYE CARE PA
Practice Location Address:

1450 66TH ST N
ST PETERSBURG, FL
33710-5504

Practice Phone: 727-381-3937
Practice Fax: 727-345-6956

1336266154 — DR. FRANK DONALD HURD O.D.
Practice Location Address:

1450 66TH ST N
SAINT PETERSBURG, FL
33710-5504

Practice Phone: 727-381-3937
Practice Fax:

1346629870 — JULIE FAITH CUBBEDGE HAS, BC-HIS
Practice Location Address:

1430 66TH ST N
ST PETERSBURG, FL
33710-5504

Practice Phone: 727-343-3019
Practice Fax: 352-351-4522

1629596572 — MYEYEDR OPTOMETRY OF FLORIDA, LLC
Practice Location Address:

1450 66TH ST N
ST PETERSBURG, FL
33710-5504

Practice Phone: 727-381-3937
Practice Fax:

1972161388 — BRANDIE SMITH AU.D.
Practice Location Address:

1430 66TH ST N
ST PETERSBURG, FL
33710-5504

Practice Phone: 727-343-3019
Practice Fax:

1922691336 — MATTHEW ALLEN MAGRUDER
Practice Location Address:

1430 66TH ST N
ST PETERSBURG, FL
33710-5504

Practice Phone: 727-343-3019
Practice Fax:

Directions to “ DR. MARK W SALTA O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.