MEDICARE: ANA DURAN-IMBACUAN RRT

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	2278G1100X	General Care Certified Respiratory Therapist
2	2279G1100X	General Care Registered Respiratory Therapist	RCP.9414	OH

General Provider Information

NPI Number	:	1881370229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA DURAN-IMBACUAN RRT

Provider Business Mailing Address
First Line	:	10701 EAST BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1702
Country	:	US
Telephone Number	:	216-791-3800
Fax Number	:	216-229-2876

Provider Business Practice Location Address
First Line	:	10701 EAST BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1702
Country	:	US
Telephone Number	:	216-791-3800
Fax Number	:	216-229-2876

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

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	06/22/2023

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