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General NPI Number Information
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NPI Number | 1487836847
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Entity Type | Organization
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Legal Business Name | HIGHLAND PODIATRY ASSOCIATES INC
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 12/06/2017
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Provider Practice Location Address
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Address Line | 850 BRAINARD RD
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City | HIGHLAND HTS
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State | OH
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Zip | 44143-3146
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Country | US
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Telephone | 440-473-0550
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Fax | 440-473-1266
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Provider Business Mailing Address
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Address Line | 850 BRAINARD RD
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City | HIGHLAND HTS
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State | OH
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Zip | 44143-3146
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Country | US
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Telephone | 440-473-0550
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Fax | 440-473-1266
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Authorized Official
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Title or Position | TAX ID OWNER
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Name | DR. DANIEL J CAVOLO
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Credential | DPM
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Telephone | 440-473-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36001699C
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License Number State | OH
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