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General NPI Number Information
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NPI Number | 1124909601
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Entity Type | Organization
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Legal Business Name | MADELINE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 600 VINE ST STE 2500
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City | CINCINNATI
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State | OH
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Zip | 45202-2491
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Country | US
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Telephone | 513-766-9264
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Fax | 513-991-4705
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Provider Business Mailing Address
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Address Line | 3135 DIXIE HWY
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City | ERLANGER
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State | KY
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Zip | 41018-6800
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Country | US
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Telephone | 513-766-9264
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Fax | 513-991-4705
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. STEFANNY SANTANA RIVERA
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Credential | MD
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Telephone | 513-766-9264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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