Provider Demographics
NPI:1720682636
Name:VLAINIC, ALLAN PAUL
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:PAUL
Last Name:VLAINIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17600 FERNSHAW AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-4145
Mailing Address - Country:US
Mailing Address - Phone:216-319-9156
Mailing Address - Fax:
Practice Address - Street 1:11570 GLENDORA LN
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3938
Practice Address - Country:US
Practice Address - Phone:216-319-9156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18182243747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0067022Medicaid