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NPI Code Detail

MEDICARE: JAIME FUENTES

MEDICARE:   JAIME  FUENTES
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
11041C0700XClinical Social WorkerI.2103223OH

General Provider Information

NPI Number : 1922370329
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIME FUENTES
Provider Business Mailing Address
First Line : 7000 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-4014
Country : US
Telephone Number : 330-224-9878
Fax Number :
Provider Business Practice Location Address
First Line : 7000 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-4014
Country : US
Telephone Number : 216-391-0264
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2012
Last Update Date : 12/01/2021

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Directions to “ JAIME FUENTES ” Practice Location

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