Healthcare Provider Details

I. General information

NPI: 1356489132
Provider Name (Legal Business Name): MARCELO P GOMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARCELO P VILLA-FORTE GOMES MD

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # DESKJ3-5
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 800-223-2273
  • Fax:
Mailing address:
  • Phone: 216-444-3352
  • Fax: 216-636-6955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35075247
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: