Provider Demographics
NPI:1679762462
Name:MARCELO, JOANNA ALCABASA
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:ALCABASA
Last Name:MARCELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 PIEDMONT DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3823
Mailing Address - Country:US
Mailing Address - Phone:352-688-5675
Mailing Address - Fax:
Practice Address - Street 1:6151 PIEDMONT DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-3823
Practice Address - Country:US
Practice Address - Phone:352-688-5675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028981225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist