Provider Demographics
NPI:1316974751
Name:DROTOS, SANDRA M
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:DROTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:M
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:533 BAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-4106
Mailing Address - Country:US
Mailing Address - Phone:330-541-5488
Mailing Address - Fax:440-398-0500
Practice Address - Street 1:533 BAYHILL DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012
Practice Address - Country:US
Practice Address - Phone:330-541-5488
Practice Address - Fax:440-398-0500
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH002860225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH002860OtherOT #