Healthcare Provider Details

I. General information

NPI: 1154476075
Provider Name (Legal Business Name): LORAIN SURGICAL SPECIALTIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N LEAVITT RD
AMHERST OH
44001-1131
US

IV. Provider business mailing address

20545 CENTER RIDGE RD SUITE 116
ROCKY RIVER OH
44116-3430
US

V. Phone/Fax

Practice location:
  • Phone: 440-985-1802
  • Fax: 440-985-1488
Mailing address:
  • Phone: 440-333-6545
  • Fax: 440-331-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSEMARY I MORONI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 440-985-1802