Provider Demographics
NPI:1164307716
Name:SALCEDO, MARCELO (DPT)
Entity type:Individual
Prefix:
First Name:MARCELO
Middle Name:
Last Name:SALCEDO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 UNIVERSITY BLVD S STE 4
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4318
Mailing Address - Country:US
Mailing Address - Phone:904-733-8133
Mailing Address - Fax:901-739-9066
Practice Address - Street 1:3716 UNIVERSITY BLVD S STE 4
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4318
Practice Address - Country:US
Practice Address - Phone:904-733-8133
Practice Address - Fax:904-739-9006
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT43425225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist