Provider Demographics
NPI:1992990618
Name:CLEVELAND CLINIC
Entity type:Organization
Organization Name:CLEVELAND CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-973-3321
Mailing Address - Street 1:29800 BAINBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2202
Mailing Address - Country:US
Mailing Address - Phone:440-519-6956
Mailing Address - Fax:440-519-3004
Practice Address - Street 1:29800 BAINBRIDGE RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2202
Practice Address - Country:US
Practice Address - Phone:440-519-6956
Practice Address - Fax:440-519-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011387261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy