Healthcare Provider Details

I. General information

NPI: 1437315488
Provider Name (Legal Business Name): CAITLIN FILIPS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

487 W BAGLEY RD
BEREA OH
44017-1326
US

IV. Provider business mailing address

487 W BAGLEY RD
BEREA OH
44017-1326
US

V. Phone/Fax

Practice location:
  • Phone: 440-891-1940
  • Fax: 440-891-9028
Mailing address:
  • Phone: 440-891-1940
  • Fax: 440-891-9028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5791-T2705
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: