Provider Demographics
NPI:1689421158
Name:SALVA, STEPHANIE
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:SALVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 TURNBULL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-1737
Mailing Address - Country:US
Mailing Address - Phone:703-407-4970
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE STE 186
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4675
Practice Address - Country:US
Practice Address - Phone:407-303-9727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL48-44-2828832247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other