Individual
MR. ABELARDO DORANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
33560 DETROIT RD, AVON, OH 44011-2030
(440) 937-4222
(440) 937-4522
Mailing address
33560 DETROIT RD, AVON, OH 44011-2030
(440) 937-4222
(440) 937-4522
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-06257
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368716
ANTHEM BC/BS
OH
05
—
2584056
—
OH
01
—
65-1193513035
CARESOURCE
OH
01
—
P00227956
MEDICARE RAILROAD
OH
Enumeration date
10/04/2006
Last updated
07/09/2007
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