Provider Demographics
NPI:1013545938
Name:BERTOLONI MELI, SOFIA ADA (MD)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:ADA
Last Name:BERTOLONI MELI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2147 E MEADOWBLUFF CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-6885
Mailing Address - Country:US
Mailing Address - Phone:812-219-3857
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Practice Address - Street 2:11100 EUCLID AVE
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-3722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program