Provider Demographics
NPI:1174583546
Name:SALANGA, VIRGILIO (MD)
Entity type:Individual
Prefix:
First Name:VIRGILIO
Middle Name:
Last Name:SALANGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 E HOLBROOK ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-0637
Mailing Address - Country:US
Mailing Address - Phone:954-661-2249
Mailing Address - Fax:480-656-4493
Practice Address - Street 1:912 E HOLBROOK ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-0637
Practice Address - Country:US
Practice Address - Phone:954-661-2249
Practice Address - Fax:480-656-4493
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00571642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047674900Medicaid
FLC01017Medicare UPIN