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General NPI Number Information
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NPI Number | 1063343903
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Entity Type | Individual
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Provider Name | SIMILA SAMA TITA I
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Gender | Male
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Dates
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Enumeration Date | 05/28/2026
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Last Update Date | 05/28/2026
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Provider Practice Location Address
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Address Line | 26401 EMERY RD STE 108
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City | WARRENSVILLE HEIGHTS
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State | OH
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Zip | 44128-6210
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Country | US
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Telephone | 216-373-1670
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Fax | 330-308-0695
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Provider Business Mailing Address
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Address Line | 26401 EMERY RD STE 108
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City | WARRENSVILLE HEIGHTS
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State | OH
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Zip | 44128-6210
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Country | US
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Telephone | 216-373-1670
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Fax | 330-308-0695
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 6495912708ST
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License Number State | OH
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