Healthcare Provider Details

I. General information

NPI: 1245363613
Provider Name (Legal Business Name): HECTOR MANUEL FELIX HS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 E 9TH ST 2693
CLEVELAND OH
44199-2001
US

IV. Provider business mailing address

1240 E 9TH ST 2693
CLEVELAND OH
44199-2001
US

V. Phone/Fax

Practice location:
  • Phone: 216-902-6373
  • Fax: 216-902-6197
Mailing address:
  • Phone: 216-902-6373
  • Fax: 216-902-6197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: