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General NPI Number Information
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NPI Number | 1861530586
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Entity Type | Individual
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Provider Name | DENA SUSAN CALTRIDER MSPT
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Gender | Female
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 1525 HERBERT ST UNIT 102-103
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City | PORT ORANGE
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State | FL
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Zip | 32129-6106
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Country | US
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Telephone | 386-756-0424
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Fax | 386-756-0425
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Provider Business Mailing Address
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Address Line | 1524 SW GOPHER TRL
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City | PALM CITY
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State | FL
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Zip | 34990-2759
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Country | US
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Telephone | 407-443-3226
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 21827
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License Number State | FL
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