Bautista, Irene H
Bautista, Irene H is an sole proprietor health care provider with primary practice located at 17951 Jefferson Park Rd , Cleveland OH 44130-8439. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bautista, Irene H can be contacted via phone (440) 816-6414.Contact Information
Primary practice address
17951 Jefferson Park Rd
Cleveland OH 44130-8439
Phone: (440) 816-6414
Fax: (440) 816-6421
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35048439B | Ohio |
Profile Details
| NPI number | 1659311660 |
|---|---|
| LBN Legal business name | Bautista, Irene H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Mar 23rd, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659311660 | NPPES |
| Ohio | MEDICAID | 0507624 |
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