Provider Demographics
NPI:1932195005
Name:SALANSKY, JENNIFER C (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:C
Last Name:SALANSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8787 BRYAN DAIRY RD STE 250
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1259
Mailing Address - Country:US
Mailing Address - Phone:727-391-6296
Mailing Address - Fax:813-635-7940
Practice Address - Street 1:8787 BRYAN DAIRY RD STE 250
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1259
Practice Address - Country:US
Practice Address - Phone:727-391-6296
Practice Address - Fax:813-635-7940
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268505100Medicaid
FLP00713485OtherRAILROAD MEDICARE PROVIDER NUMBER
FL37312YMedicare PIN
FL268505100Medicaid