Juan Carlos Gonzalez Salazar

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Milton, PA

NPI 1295539104 · NPPES record last updated Apr 1, 2025

Key facts

NPI
1295539104
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
155 S Arch St
Milton, PA 17847-1172
Phone
(570) 742-2655
NPI assigned
Apr 1, 2025
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250604000901 PA Order and Referring Only - Internal Medicine
Practitioner - Pediatric Medicine
Practitioner - Internal Medicine
4183133887

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

155 S Arch St
Milton, PA 17847-1172

Mailing address

155 S Arch St
Milton, PA 17847-1172
Phone (570) 742-2655

Other providers in Milton, PA

All providers in Milton, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

Verify at the official NPI Registry.