MEDICARE: YANIRA MIROSLAVA ALVARADO

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1871075879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANIRA MIROSLAVA ALVARADO

Provider Business Mailing Address
First Line	:	3907 W 158TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-4272
Country	:	US
Telephone Number	:	216-235-2385
Fax Number	:

Provider Business Practice Location Address
First Line	:	3907 W 158 ST.
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-4411
Country	:	US
Telephone Number	:	216-235-2385
Fax Number	:

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

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

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Directions to “ YANIRA MIROSLAVA ALVARADO ” Practice Location

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