Provider Demographics
NPI:1235956913
Name:SALINAS TORRA, ANDREA TIBISAY
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:TIBISAY
Last Name:SALINAS TORRA
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 1:101 HOWLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-9200
Mailing Address - Country:US
Mailing Address - Phone:407-328-9414
Mailing Address - Fax:407-328-9386
Practice Address - Street 1:101 HOWLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-9200
Practice Address - Country:US
Practice Address - Phone:407-322-8941
Practice Address - Fax:407-328-9386
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist