Provider Demographics
NPI:1902075344
Name:CLEVELAND CLINIC FOUNDATION
Entity type:Organization
Organization Name:CLEVELAND CLINIC FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:EMILIA
Authorized Official - Last Name:MARTIRENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-444-2200
Mailing Address - Street 1:30987 KILGOUR DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-6833
Mailing Address - Country:US
Mailing Address - Phone:440-871-0693
Mailing Address - Fax:440-871-0693
Practice Address - Street 1:30987 KILGOUR DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6833
Practice Address - Country:US
Practice Address - Phone:440-871-0693
Practice Address - Fax:440-871-0693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital