Healthcare Provider Details

I. General information

NPI: 1013204650
Provider Name (Legal Business Name): ANA LUCIA RUANO MENDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANA LUCIA LUCIA RUANO MD

II. Dates (important events)

Enumeration Date: 07/04/2011
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # L25
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

12463 CEDAR RD
CLEVELAND OH
44106-3221
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-6781
  • Fax:
Mailing address:
  • Phone: 216-543-6959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number57019168
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: