MEDICARE: DR. LISA E SYLVESTER 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	111N00000X	Chiropractor	3720	OH
2	390200000X	Student in an Organized Health Care Education/Training Program		OH
3	207P00000X	Emergency Medicine Physician	012206	OH

General Provider Information

NPI Number	:	1760407563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA E SYLVESTER D.O.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:	E19
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	33100 CLEVELAND CLINIC BLVD
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-1390
Country	:	US
Telephone Number	:	800-272-2676
Fax Number	:

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	10/05/2016

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