Healthcare Provider Details

I. General information

NPI: 1740509280
Provider Name (Legal Business Name): JOSE ASCENSION ARMENDARIZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 07/17/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK WEST BLVD STE 330
AKRON OH
44320-4226
US

IV. Provider business mailing address

1 PARK WEST BLVD STE 330
AKRON OH
44320-4226
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35.144911
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: