Provider Demographics
NPI:1013254309
Name:CIARLANTE, JOSEPH F (PTA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:F
Last Name:CIARLANTE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:JOSEPH
Other - Middle Name:F
Other - Last Name:CIARLANTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:4453 GLENNS LNDG
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2442
Mailing Address - Country:US
Mailing Address - Phone:863-651-1919
Mailing Address - Fax:
Practice Address - Street 1:4453 GLENNS LNDG
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-2442
Practice Address - Country:US
Practice Address - Phone:863-651-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21802225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant