Healthcare Provider Details

I. General information

NPI: 1073456133
Provider Name (Legal Business Name): SIMONE A GATEWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E 260TH ST
EUCLID OH
44132-2301
US

IV. Provider business mailing address

715 E 260TH ST
EUCLID OH
44132-2301
US

V. Phone/Fax

Practice location:
  • Phone: 216-225-8333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: