Provider Demographics
NPI:1487926036
Name:MARCELO, GERALDINE CATALAN
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:CATALAN
Last Name:MARCELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:CATALAN
Other - Last Name:MARCELO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1280 NW 125TH TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3179
Mailing Address - Country:US
Mailing Address - Phone:954-298-7522
Mailing Address - Fax:
Practice Address - Street 1:1280 NW 125TH TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3179
Practice Address - Country:US
Practice Address - Phone:954-298-7522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-28
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10356225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist