Healthcare Provider Details

I. General information

NPI: 1942777990
Provider Name (Legal Business Name): ANNA ARELLANO DORADO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 S ORANGE BLOSSOM TRL STE 102
ORLANDO FL
32809-5734
US

IV. Provider business mailing address

11244 LEDGEMENT LN
WINDERMERE FL
34786-6416
US

V. Phone/Fax

Practice location:
  • Phone: 321-445-1287
  • Fax: 407-386-7448
Mailing address:
  • Phone: 407-893-0939
  • Fax: 407-386-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number9577
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: