Healthcare Provider Details

I. General information

NPI: 1114861895
Provider Name (Legal Business Name): CONSTRUCTIVE SURGERY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 CORAL WAY STE 306
MIAMI FL
33145-2945
US

IV. Provider business mailing address

1675 MICANOPY AVE
MIAMI FL
33133-2542
US

V. Phone/Fax

Practice location:
  • Phone: 786-627-4601
  • Fax:
Mailing address:
  • Phone: 786-627-4601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER SALGADO
Title or Position: MANAGER
Credential: MD
Phone: 786-627-4601