Provider Demographics
NPI:1295976215
Name:ALVARADO, CRISELDA VILLARINO (PT)
Entity type:Individual
Prefix:
First Name:CRISELDA
Middle Name:VILLARINO
Last Name:ALVARADO
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 1:5705 QUINTON WAY
Mailing Address - Street 2:
Mailing Address - City:MT. DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757
Mailing Address - Country:US
Mailing Address - Phone:954-798-1259
Mailing Address - Fax:
Practice Address - Street 1:2810 RULEME ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6527
Practice Address - Country:US
Practice Address - Phone:352-483-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030541-1225100000X
PAPT019775225100000X
FLPT25240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist