Healthcare Provider Details

I. General information

NPI: 1427966274
Provider Name (Legal Business Name): DONAZE F MELVIN JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24799 LAKE SHORE BLVD APT 201
EUCLID OH
44123-4236
US

IV. Provider business mailing address

24799 LAKE SHORE BLVD APT 201
EUCLID OH
44123-4236
US

V. Phone/Fax

Practice location:
  • Phone: 216-512-9876
  • Fax:
Mailing address:
  • Phone: 216-512-9876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: