Provider Demographics
NPI:1760412282
Name:SALGADO, JOSE III (MPT)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:SALGADO
Suffix:III
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8973 SW CHEVY CIR
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-1306
Mailing Address - Country:US
Mailing Address - Phone:561-603-5464
Mailing Address - Fax:
Practice Address - Street 1:8973 SW CHEVY CIR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-1306
Practice Address - Country:US
Practice Address - Phone:561-603-5464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ885973Medicaid