Healthcare Provider Details

I. General information

NPI: 1023835253
Provider Name (Legal Business Name): AUDRIANA MARIE DEAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 W 25TH ST
CLEVELAND OH
44113-3108
US

IV. Provider business mailing address

1730 W 25TH ST
CLEVELAND OH
44113-3108
US

V. Phone/Fax

Practice location:
  • Phone: 216-696-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119231
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number50.009248RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: