Healthcare Provider Details

I. General information

NPI: 1609687318
Provider Name (Legal Business Name): MARTA MENDIZABAL FDNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6568 SHERBORN RD
PARMA HEIGHTS OH
44130-3954
US

IV. Provider business mailing address

15728 LORAIN AVE UNIT 300
CLEVELAND OH
44111-5542
US

V. Phone/Fax

Practice location:
  • Phone: 216-808-3600
  • Fax:
Mailing address:
  • Phone: 216-808-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: