Healthcare Provider Details

I. General information

NPI: 1457705030
Provider Name (Legal Business Name): ALEJANDRO PITA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # A120
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # A120
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-3570
  • Fax:
Mailing address:
  • Phone: 216-644-4113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA140442
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number35.140470
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: