MEDICARE: CLEVELAND TELEHEALTH LLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1932062742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND TELEHEALTH LLC

Provider Business Mailing Address
First Line	:	4453 W 51ST ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-2933
Country	:	US
Telephone Number	:	216-612-4437
Fax Number	:

Provider Business Practice Location Address
First Line	:	4453 W 51ST ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-2933
Country	:	US
Telephone Number	:	216-612-4437
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOSES ONYEKACHI NNOROM
Credential	:
Telephone Number	:	323-676-1281

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “CLEVELAND TELEHEALTH LLC ” Practice Location

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