MEDICARE: KARLO MARIANO PT

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	PT 20500	FL

General Provider Information

NPI Number	:	1346382793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLO MARIANO PT

Provider Business Mailing Address
First Line	:	4881 SUGAR MAPLE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45433-5529
Country	:	US
Telephone Number	:	937-257-8753
Fax Number	:

Provider Business Practice Location Address
First Line	:	4881 SUGAR MAPLE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45433-5529
Country	:	US
Telephone Number	:	937-257-8753
Fax Number	:

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	04/03/2018

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