Healthcare Provider Details

I. General information

NPI: 1730120791
Provider Name (Legal Business Name): UNIVERSITY OPHTHALMOLOGISTS,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1736
US

IV. Provider business mailing address

5910 LANDERBROOK DR SUITE 250
MAYFIELD HTS OH
44124-6508
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3601
  • Fax: 440-449-1555
Mailing address:
  • Phone: 440-684-5829
  • Fax: 440-449-1555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: SUBER HUANG
Title or Position: PRACTICE ADMINISTRATOR
Credential: MD
Phone: 216-844-3601