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General NPI Number Information
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NPI Number | 1801562947
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Entity Type | Individual
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Provider Name | LOUIS ZAMUDIO JR. RN
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Gender | Male
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 24100 CHAGRIN BLVD STE 125
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City | BEACHWOOD
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State | OH
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Zip | 44122-5535
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Country | US
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Telephone | 216-714-3278
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Fax |
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Provider Business Mailing Address
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Address Line | 8507 TAHOE DR
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City | MACEDONIA
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State | OH
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Zip | 44056-2734
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Country | US
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Telephone | 330-559-3029
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0032424
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.406541
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License Number State | OH
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