MEDICARE: AUSTIN MICHAEL CALANTONI DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	14064-24	WI
2	225100000X	Physical Therapist	PT33153	FL

General Provider Information

NPI Number	:	1093223893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN MICHAEL CALANTONI DPT

Provider Business Mailing Address
First Line	:	1472 FLORA RD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-1514
Country	:	US
Telephone Number	:	920-381-4472
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 MORTON PLANT ST STE 101
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3397
Country	:	US
Telephone Number	:	727-461-8331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2018
Last Update Date	:	03/20/2023

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