Provider Demographics
NPI:1588205702
Name:PAPALEO, JOANN F (PTA)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:F
Last Name:PAPALEO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 S SEMORAN BLVD STE 110A
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-5313
Mailing Address - Country:US
Mailing Address - Phone:800-521-9608
Mailing Address - Fax:
Practice Address - Street 1:75 PINE ST
Practice Address - Street 2:
Practice Address - City:DEPOSIT
Practice Address - State:NY
Practice Address - Zip Code:13754-1146
Practice Address - Country:US
Practice Address - Phone:607-240-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002844-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant