Healthcare Provider Details

I. General information

NPI: 1982177184
Provider Name (Legal Business Name): MARISOL SALGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 N KENDALL DR STE 211
MIAMI FL
33176-2198
US

IV. Provider business mailing address

9960 NW 116TH WAY STE 13
MEDLEY FL
33178-1175
US

V. Phone/Fax

Practice location:
  • Phone: 305-273-3007
  • Fax:
Mailing address:
  • Phone: 786-924-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF12180919
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: