Provider Demographics
NPI:1578818142
Name:STELATO, CRISTIANE ESTEVES (PT)
Entity Type:Individual
Prefix:
First Name:CRISTIANE
Middle Name:ESTEVES
Last Name:STELATO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5238 NE 6TH AVE APT 26A
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3333
Mailing Address - Country:US
Mailing Address - Phone:954-621-5368
Mailing Address - Fax:
Practice Address - Street 1:3221 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6452
Practice Address - Country:US
Practice Address - Phone:610-925-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist