MEDICARE: SIMILA SAMA TITA I

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	171M00000X	Case Manager/Care Coordinator	6495912708ST	OH

General Provider Information

NPI Number	:	1063343903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMILA SAMA TITA I

Provider Business Mailing Address
First Line	:	26401 EMERY RD STE 108
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44128-6210
Country	:	US
Telephone Number	:	216-373-1670
Fax Number	:	330-308-0695

Provider Business Practice Location Address
First Line	:	26401 EMERY RD STE 108
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44128-6210
Country	:	US
Telephone Number	:	216-373-1670
Fax Number	:	330-308-0695

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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