Provider Demographics
NPI:1013384676
Name:CERRADO, MARY CHRISTINE (PT, DPT, OCS)
Entity Type:Individual
Prefix:DR
First Name:MARY CHRISTINE
Middle Name:
Last Name:CERRADO
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HILDA ST STE 12
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-2359
Mailing Address - Country:US
Mailing Address - Phone:407-933-6684
Mailing Address - Fax:407-933-6611
Practice Address - Street 1:201 HILDA ST STE 12
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2359
Practice Address - Country:US
Practice Address - Phone:407-933-6684
Practice Address - Fax:407-933-6611
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist