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Individual

DR. MARK W SALTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1450 66TH ST N, ST PETERSBURG, FL 33710-5504
(727) 381-3937
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2252
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
078666700
FL
Enumeration date
08/11/2005
Last updated
03/10/2022
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