Provider Demographics
NPI:1861544959
Name:BERIN, MARIA CIELITO ALMA MACEDA (PT)
Entity type:Individual
Prefix:MRS
First Name:MARIA CIELITO ALMA
Middle Name:MACEDA
Last Name:BERIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:CINDY
Other - Middle Name:MACEDA
Other - Last Name:BERIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:341 S WOODFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-9070
Mailing Address - Country:US
Mailing Address - Phone:812-825-8815
Mailing Address - Fax:812-825-8815
Practice Address - Street 1:2536 INDUSTRIAL DRIVE
Practice Address - Street 2:SUITE 10-11
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47303
Practice Address - Country:US
Practice Address - Phone:812-332-7529
Practice Address - Fax:812-339-7529
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006267A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics