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General NPI Number Information
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NPI Number | 1821655994
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Entity Type | Individual
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Provider Name | LIDA ZEINALPOUR OD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 9485 MENTOR AVE STE 110
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City | MENTOR
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State | OH
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Zip | 44060-8724
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Country | US
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Telephone | 440-255-1115
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 NORTON PKWY STE 110
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City | MENTOR
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State | OH
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Zip | 44060-6017
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Country | US
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Telephone | 440-255-1115
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.006768
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License Number State | OH
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