MEDICARE: MICHAEL MENOLASINO DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	34007904M	OH
2	208M00000X	Hospitalist Physician	V3184	TX
3	207R00000X	Internal Medicine Physician	OS21476	FL
4	207R00000X	Internal Medicine Physician	V3184	TX
5	208M00000X	Hospitalist Physician	34.007904	OH
6	208M00000X	Hospitalist Physician	OS21476	FL

General Provider Information

NPI Number	:	1063592459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MENOLASINO DO

Provider Business Mailing Address
First Line	:	PO BOX 74130
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44194-0218
Country	:	US
Telephone Number	:	440-585-6000
Fax Number	:	440-585-6141

Provider Business Practice Location Address
First Line	:	27100 CHARDON RD
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-1116
Country	:	US
Telephone Number	:	216-383-0100
Fax Number	:	216-383-6481

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	12/16/2024

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