MEDICARE: FLORIDEO PASSARELLI 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	5501303676	MI

General Provider Information

NPI Number	:	1770397077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORIDEO PASSARELLI DPT

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 RENAISSANCE CTR STE 1202
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48243-1300
Country	:	US
Telephone Number	:	313-334-4302
Fax Number	:	313-307-0099

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

Provider Enumeration Date	:	02/05/2025
Last Update Date	:	12/31/2025

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Directions to “ FLORIDEO PASSARELLI DPT” Practice Location

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