Healthcare Provider Details

I. General information

NPI: 1124637566
Provider Name (Legal Business Name): MARIBEL LLAMAS RANGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR
CLEVELAND OH
44109-1998
US

IV. Provider business mailing address

2500 METROHEALTH DR
CLEVELAND OH
44109-1998
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-7353
  • Fax:
Mailing address:
  • Phone: 216-778-7353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03439984
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: