Provider Demographics
NPI:1124317722
Name:BIAGINI, DOLORES THERESA (PT)
Entity type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:THERESA
Last Name:BIAGINI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:THERESA
Other - Last Name:BIAGINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 1367
Mailing Address - Street 2:
Mailing Address - City:WALDOBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04572-1367
Mailing Address - Country:US
Mailing Address - Phone:207-832-5544
Mailing Address - Fax:207-832-5507
Practice Address - Street 1:400 TAMIAMI TRL S
Practice Address - Street 2:SUITE #210
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2614
Practice Address - Country:US
Practice Address - Phone:941-483-3400
Practice Address - Fax:941-483-3422
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist