Healthcare Provider Details

I. General information

NPI: 1255170353
Provider Name (Legal Business Name): FB MEDICAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24080 GLENBROOK BLVD
EUCLID OH
44117-1969
US

IV. Provider business mailing address

25000 EUCLID AVE SUITE 305#1118
EUCLID OH
44117-1969
US

V. Phone/Fax

Practice location:
  • Phone: 440-470-2822
  • Fax:
Mailing address:
  • Phone: 833-663-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE FERGUSON
Title or Position: CEO
Credential:
Phone: 440-470-2822