Provider Demographics
NPI:1225278856
Name:ABRAHANO, ANTONIO M JR (R P T)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:M
Last Name:ABRAHANO
Suffix:JR
Gender:M
Credentials:R P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 TEMPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-2351
Mailing Address - Country:US
Mailing Address - Phone:310-720-8313
Mailing Address - Fax:
Practice Address - Street 1:8529 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4014
Practice Address - Country:US
Practice Address - Phone:562-862-8755
Practice Address - Fax:562-861-8850
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 11516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist