Healthcare Provider Details

I. General information

NPI: 1437067238
Provider Name (Legal Business Name): MARCO ANTONIO SALGADO JR. PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 SW 136TH PL
MIAMI FL
33184-1810
US

IV. Provider business mailing address

1516 SW 136TH PL
MIAMI FL
33184-1810
US

V. Phone/Fax

Practice location:
  • Phone: 786-473-6606
  • Fax:
Mailing address:
  • Phone: 786-473-6606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP11050567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: