Basic Information
| Provider Information | |||||||||
| NPI: | 1740621770 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALDOVINO | ||||||||
| FirstName: | FRANKLIN | ||||||||
| MiddleName: | CUNA | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12041 BOURNEFIELD WAY STE B | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209047908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015924400 | ||||||||
| FaxNumber: | 3018699809 | ||||||||
| Practice Location | |||||||||
| Address1: | 12041 BOURNEFIELD WAY STE B | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209047908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015924400 | ||||||||
| FaxNumber: | 3018699809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2013 | ||||||||
| LastUpdateDate: | 05/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 24396 | MD | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 031034 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 24395 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.