Healthcare Provider Details
I. General information
NPI: 1013024793
Provider Name (Legal Business Name): RICHARD A ZINNI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/25/2006
Last Update Date: 05/13/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13301 MILES AVE
CLEVELAND OH
44105-5521
US
IV. Provider business mailing address
7956 TYLER BLVD
MENTOR OH
44060-4806
US
V. Phone/Fax
- Phone: 216-751-3100
- Fax: 216-751-2480
- Phone: 440-255-4455
- Fax: 440-255-4487
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | 34.003785 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 34-003785 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 34-003785 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: