Healthcare Provider Details

I. General information

NPI: 1184346140
Provider Name (Legal Business Name): ENCORE CLINICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 RIDGE RD
NORTH ROYALTON OH
44133-3744
US

IV. Provider business mailing address

12301 RIDGE RD
NORTH ROYALTON OH
44133-3744
US

V. Phone/Fax

Practice location:
  • Phone: 440-652-8748
  • Fax: 440-582-3171
Mailing address:
  • Phone: 440-582-3171
  • Fax: 440-582-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. MIROSLAV KESIC
Title or Position: OWNER
Credential:
Phone: 609-513-5006