MEDICARE: ZERO DOUBT CLUB CLEVELAND EAST LLC

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1164220950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZERO DOUBT CLUB CLEVELAND EAST LLC

Provider Business Mailing Address
First Line	:	5885 LANDERBROOK DR
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5885 LANDERBROOK DR
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4045
Country	:	US
Telephone Number	:	216-470-9088
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ERIC GOLUBITSKY
Credential	:
Telephone Number	:	216-470-9088

Provider Enumeration Date	:	03/06/2025
Last Update Date	:	03/06/2025

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