Provider Demographics
NPI:1275932675
Name:PANTALEO, STEPHANIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:PANTALEO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:ACUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 64207
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85728-4207
Mailing Address - Country:US
Mailing Address - Phone:520-829-7712
Mailing Address - Fax:520-314-3141
Practice Address - Street 1:3305 N SWAN RD STE 115
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1273
Practice Address - Country:US
Practice Address - Phone:520-321-0204
Practice Address - Fax:520-321-0495
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN555850045Medicare PIN