Provider Demographics
NPI:1972099398
Name:LALINDE, YIRAVANNEX LOPEZ
Entity type:Individual
Prefix:MS
First Name:YIRAVANNEX
Middle Name:LOPEZ
Last Name:LALINDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 SPRING RD APT 140
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-4429
Mailing Address - Country:US
Mailing Address - Phone:216-327-9373
Mailing Address - Fax:
Practice Address - Street 1:1331 W 70TH ST APT 610
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2056
Practice Address - Country:US
Practice Address - Phone:216-772-9347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH85950374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH85950Medicaid