Individual
DR. JOSEPH BOLANAN SALENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8773 PERIMETER PARK CT, JACKSONVILLE, FL 32216-1165
(904) 493-3390
(904) 493-3395
Mailing address
8773 PERIMETER PARK CT, JACKSONVILLE, FL 32216-1165
(904) 493-3390
(904) 493-3395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261577
NY
207R00000X
Internal Medicine Physician
ME114390
FL
208M00000X
Hospitalist Physician
Primary
ME114390
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003174381A
GEORGIA MEDICAID
GA
05
—
0083955-00
—
FL
01
—
14P3S
FLORIDA BLUE
FL
01
—
2610299-00
MEDICAID GROUP
FL
01
—
363224
AVMED
FL
01
—
45681
MEDICARE - GROUP
FL
01
—
786594
WELLCARE
FL
01
—
GY389Z
MEDICARE - INDIVIDUAL
FL
01
—
P01202783
RR MEDICARE
FL
Enumeration date
12/06/2008
Last updated
08/04/2016
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