Provider Demographics
NPI:1790678092
Name:DIPADOVA, LEONARDO MARIO
Entity type:Individual
Prefix:
First Name:LEONARDO
Middle Name:MARIO
Last Name:DIPADOVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3136 ASPEN LN
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-4946
Mailing Address - Country:US
Mailing Address - Phone:216-633-7254
Mailing Address - Fax:
Practice Address - Street 1:1401 S ARCH AVE STE A
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4288
Practice Address - Country:US
Practice Address - Phone:330-249-7011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer