Healthcare Provider Details

I. General information

NPI: 1649236068
Provider Name (Legal Business Name): JONATHAN MICHAEL NAFT LPO, LPED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13376 RAVENNA RD
CHARDON OH
44024-9007
US

IV. Provider business mailing address

18933 HIGH POINT RD
CHAGRIN FALLS OH
44023-5074
US

V. Phone/Fax

Practice location:
  • Phone: 440-285-5785
  • Fax: 440-285-5786
Mailing address:
  • Phone: 440-285-5785
  • Fax: 440-285-5786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License NumberLPO78; LPED39
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: