Basic Information
Provider Information
NPI: 1376521120
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMOS
FirstName: OLGA
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 74253
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441940002
CountryCode: US
TelephoneNumber: 4408790081
FaxNumber: 4408790084
Practice Location
Address1: 18901 LAKE SHORE BLVD
Address2:  
City: EUCLID
State: OH
PostalCode: 441191078
CountryCode: US
TelephoneNumber: 2165319000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XNP-07786OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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