Organization Name: | CLEVELAND NEPHROLOGY, PLLC |
NPI Number: | 1003146382 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | OSWALD LLANDEROSOS (OWNER/MEMBER) |
Mailing Address: | 1059 Se 82nd Oklahoma City |
State: | OK US |
Postal Code: | 73149 |
Phone Number: | 4055126912 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2010 |
NPI Last Update Date: | 01/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |