MEDICARE: A'DIVA WARREN AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	A.02636	OH

General Provider Information

NPI Number	:	1033048764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	A'DIVA WARREN AUD

Provider Business Mailing Address
First Line	:	351 E 264TH ST
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44132-1442
Country	:	US
Telephone Number	:	216-502-6249
Fax Number	:

Provider Business Practice Location Address
First Line	:	26900 CEDAR RD
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-1191
Country	:	US
Telephone Number	:	216-839-3740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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