=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265707624
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMMA CALDERONE PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2012
-----------------------------------------------------
Last Update Date | 03/19/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12301 LAKE UNDERHILL RD SUITE 118
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32828-4508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-218-4660
-----------------------------------------------------
Fax | 407-218-4661
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 4605
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32793-4605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-218-4660
-----------------------------------------------------
Fax | 407-218-4661
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number | 27225
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------