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General NPI Number Information
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NPI Number | 1033988928
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Entity Type | Organization
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Legal Business Name | CLEVELAND ORTHOPEDIC AND SPINE INSTITUTE, LLC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 300 ALLEN BRADLEY DR STE 200
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-6130
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Country | US
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Telephone | 844-746-8537
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Fax |
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Provider Business Mailing Address
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Address Line | 300 ALLEN BRADLEY DR STE 200
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-6130
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Country | US
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Telephone | 407-307-7652
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | MARY EBERT
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Credential |
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Telephone | 614-260-2357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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