Healthcare Provider Details

I. General information

NPI: 1033048764
Provider Name (Legal Business Name): A'DIVA WARREN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26900 CEDAR RD
BEACHWOOD OH
44122-1191
US

IV. Provider business mailing address

351 E 264TH ST
EUCLID OH
44132-1442
US

V. Phone/Fax

Practice location:
  • Phone: 216-839-3740
  • Fax:
Mailing address:
  • Phone: 216-502-6249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.02636
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: