Provider Demographics
NPI:1780717520
Name:ADVANCED PERITONEAL DIALYSIS, LLC
Entity type:Organization
Organization Name:ADVANCED PERITONEAL DIALYSIS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:FLAUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-292-0231
Mailing Address - Street 1:9050 N CHURCH DR
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4701
Mailing Address - Country:US
Mailing Address - Phone:440-292-0231
Mailing Address - Fax:440-292-0234
Practice Address - Street 1:9050 N CHURCH DR
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4701
Practice Address - Country:US
Practice Address - Phone:440-292-0231
Practice Address - Fax:440-292-0234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0892DC261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2733475Medicaid
OH2733475Medicaid