Provider Demographics
NPI:1316706914
Name:CALZADO, MACARENA (PT, DPT)
Entity type:Individual
Prefix:
First Name:MACARENA
Middle Name:
Last Name:CALZADO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 EDGEWATER DR APT 805
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1759
Mailing Address - Country:US
Mailing Address - Phone:216-548-2999
Mailing Address - Fax:
Practice Address - Street 1:2101 ADELBERT RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2624
Practice Address - Country:US
Practice Address - Phone:216-844-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist