MEDICARE: JONATHAN EVAN KURLANSIK D.O.

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	207P00000X	Emergency Medicine Physician	34.015162	OH

General Provider Information

NPI Number	:	1326537697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN EVAN KURLANSIK D.O.

Provider Business Mailing Address
First Line	:	1853 WEST 48TH STREET
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29000 CENTER RIDGE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44145-5219
Country	:	US
Telephone Number	:	440-835-8000
Fax Number	:

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

Provider Enumeration Date	:	05/02/2018
Last Update Date	:	05/09/2022

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