MEDICARE: DR. LISA CHRISTINE NAVRACRUZ MD

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	207Q00000X	Family Medicine Physician	35-08-2896-N	OH

General Provider Information

NPI Number	:	1124025093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA CHRISTINE NAVRACRUZ MD

Provider Business Mailing Address
First Line	:	2215 LAMBERTON RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2811
Country	:	US
Telephone Number	:	216-781-6724
Fax Number	:	216-781-6723

Provider Business Practice Location Address
First Line	:	1530 SAINT CLAIR AVE NE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-2004
Country	:	US
Telephone Number	:	216-781-6724
Fax Number	:	216-781-6723

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

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	04/30/2009

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