Provider Demographics
NPI:1093832305
Name:CALES, RAFAEL III (PTA)
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:
Last Name:CALES
Suffix:III
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 MELANIE CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-8427
Mailing Address - Country:US
Mailing Address - Phone:321-837-1953
Mailing Address - Fax:
Practice Address - Street 1:4001 STACK BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-8500
Practice Address - Country:US
Practice Address - Phone:321-676-9011
Practice Address - Fax:321-676-9011
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA19701225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant