Basic Information
| Provider Information | |||||||||
| NPI: | 1043766983 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FELICIANO SALVA | ||||||||
| FirstName: | KARLA | ||||||||
| MiddleName: | JENISSE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 365067 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009365067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | HC 3 BOX 4684 | ||||||||
| Address2: | |||||||||
| City: | ADJUNTAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006019309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872140616 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2016 | ||||||||
| LastUpdateDate: | 10/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 022043 | PR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 22043 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 22043 | 01 | PR | MEDICAL LIC | OTHER |