Healthcare Provider Details

I. General information

NPI: 1992631774
Provider Name (Legal Business Name): MARIAN TERESA SALGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 6 MILE CYPRESS PKWY
FORT MYERS FL
33966-6510
US

IV. Provider business mailing address

21381 S BRANCH BLVD UNIT 2202
ESTERO FL
33928-9749
US

V. Phone/Fax

Practice location:
  • Phone: 239-329-0989
  • Fax:
Mailing address:
  • Phone: 224-607-7440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN31775
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: