Healthcare Provider Details

I. General information

NPI: 1356922116
Provider Name (Legal Business Name): LADD LAYA-CABALLERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # F-30
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # F-30
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-633-7734
  • Fax:
Mailing address:
  • Phone: 216-633-7734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number57.261313
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: