Healthcare Provider Details

I. General information

NPI: 1477858645
Provider Name (Legal Business Name): MICKIE GUARINO NEWLAND P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18901 LAKE SHORE BLVD
EUCLID OH
44119-1078
US

IV. Provider business mailing address

1611 S GREEN RD SUITE 036
SOUTH EUCLID OH
44121-4129
US

V. Phone/Fax

Practice location:
  • Phone: 216-576-8818
  • Fax:
Mailing address:
  • Phone: 216-291-2277
  • Fax: 216-291-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT013136
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: