Healthcare Provider Details

I. General information

NPI: 1518621663
Provider Name (Legal Business Name): RADIANT DERMATOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6990 LINDSAY DR STE 5
MENTOR OH
44060-4981
US

IV. Provider business mailing address

6990 LINDSAY DR STE 5
MENTOR OH
44060-4981
US

V. Phone/Fax

Practice location:
  • Phone: 440-290-9616
  • Fax:
Mailing address:
  • Phone: 440-290-9616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MIRIAM FINKEL
Title or Position: OWNER
Credential: MD
Phone: 440-290-9616