MEDICARE: MRS. MARIA CHAMORRO

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	3747P1801X	Personal Care Attendant
2	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1851128771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA CHAMORRO

Provider Business Mailing Address
First Line	:	4162 W 57TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-1852
Country	:	US
Telephone Number	:	325-812-3646
Fax Number	:

Provider Business Practice Location Address
First Line	:	4162 W 57TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-1852
Country	:	US
Telephone Number	:	325-812-3646
Fax Number	:

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

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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Directions to “ MRS. MARIA CHAMORRO ” Practice Location

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