Provider Demographics
NPI:1871854588
Name:CALAPATIA, REGALADO DIMAZANA II (RPT)
Entity Type:Individual
Prefix:
First Name:REGALADO
Middle Name:DIMAZANA
Last Name:CALAPATIA
Suffix:II
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 SAGRASS CORPORATE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2860
Mailing Address - Country:US
Mailing Address - Phone:954-257-6894
Mailing Address - Fax:866-422-6431
Practice Address - Street 1:1580 SAWGRASS CORP PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2860
Practice Address - Country:US
Practice Address - Phone:954-257-6894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist