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Organization
SALUD PRIMARY CARE LLC
Active
Organization
SALUD PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA RUSSELL NP (OWNER)
(904) 625-2644
Entity
Organization
Contact information
Practice address
1126 UNIVERSITY BLVD N STE 3105, JACKSONVILLE, FL 32211-8850
(904) 625-2644
Mailing address
379 TINTAMARRE DR, SAINT AUGUSTINE, FL 32092-1102
(904) 625-2644
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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