Provider Demographics
NPI:1093223893
Name:CALANTONI, AUSTIN MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:MICHAEL
Last Name:CALANTONI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1472 FLORA RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-1514
Mailing Address - Country:US
Mailing Address - Phone:920-381-4472
Mailing Address - Fax:
Practice Address - Street 1:430 MORTON PLANT ST STE 101
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3397
Practice Address - Country:US
Practice Address - Phone:727-461-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14064-24225100000X
FLPT33153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist