MEDICARE: ONE STOP SERVICES CORP

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1063741122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE STOP SERVICES CORP

Provider Business Mailing Address
First Line	:	PO BOX 10563
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-0563
Country	:	US
Telephone Number	:	713-417-4121
Fax Number	:

Provider Business Practice Location Address
First Line	:	1234 N CROWN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45999-0001
Country	:	US
Telephone Number	:	713-417-4121
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JESUS RODRIGUEZ
Credential	:
Telephone Number	:	713-417-4121

Provider Enumeration Date	:	12/18/2009
Last Update Date	:	12/18/2009

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Directions to “ONE STOP SERVICES CORP ” Practice Location

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