Healthcare Provider Details

I. General information

NPI: 1578818142
Provider Name (Legal Business Name): CRISTIANE ESTEVES STELATO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 07/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 FRUITVILLE RD
SARASOTA FL
34237-6452
US

IV. Provider business mailing address

5238 NE 6TH AVE APT 26A
FORT LAUDERDALE FL
33334-3333
US

V. Phone/Fax

Practice location:
  • Phone: 610-925-4253
  • Fax:
Mailing address:
  • Phone: 954-621-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number24470
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: