Healthcare Provider Details

I. General information

NPI: 1083816367
Provider Name (Legal Business Name): HEATHER KUHLENSCHMIDT JIMENEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER LEE KUHLENSCHMIDT MD

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE E-12
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE E-19
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-870-9820
  • Fax:
Mailing address:
  • Phone: 216-870-9820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number11013279A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number01065330A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35099952
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: