Provider Demographics
NPI:1215571195
Name:KOPASAKIS, PATRICIA MARIANO (PT, DPT, SCS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIANO
Last Name:KOPASAKIS
Suffix:
Gender:F
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:THERESE
Other - Last Name:MARIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, SCS
Mailing Address - Street 1:33100 CLEVELAND CLINIC BLVD # 1-1
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1390
Mailing Address - Country:US
Mailing Address - Phone:440-695-4547
Mailing Address - Fax:
Practice Address - Street 1:33100 CLEVELAND CLINIC BLVD # 1-1
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1390
Practice Address - Country:US
Practice Address - Phone:440-695-4547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0154122251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports