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General NPI Number Information
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NPI Number | 1518555382
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Entity Type | Organization
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Legal Business Name | CLEVELAND EAST VASCULAR CARE, LLC
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Dates
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Enumeration Date | 01/06/2021
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 23650 COMMERCE PARK STE A
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City | BEACHWOOD
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State | OH
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Zip | 44122-5817
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Country | US
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Telephone | 239-597-2010
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Fax | 216-378-9005
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Provider Business Mailing Address
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Address Line | 9140 CORSEA DEL FONTANA WAY
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City | NAPLES
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State | FL
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Zip | 34109-4397
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Country | US
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Telephone | 239-597-2010
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Fax | 239-597-2313
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Authorized Official
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Title or Position | CFO
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Name | LISA MCNAMARA
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Credential |
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Telephone | 239-597-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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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 | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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