Healthcare Provider Details

I. General information

NPI: 1245410372
Provider Name (Legal Business Name): ANGELA M HORVATH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33100 CLEVELAND CLINIC BLVD
AVON OH
44011-1390
US

IV. Provider business mailing address

24701 EUCLID AVE THIRD FLOOR
EUCLID OH
44117-1714
US

V. Phone/Fax

Practice location:
  • Phone: 440-695-4950
  • Fax:
Mailing address:
  • Phone: 216-593-5500
  • Fax: 216-201-5310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50002196
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: