Provider Demographics
NPI:1073683868
Name:DR. CARIDAD C. AGDINAOAY, MD, INC.
Entity Type:Organization
Organization Name:DR. CARIDAD C. AGDINAOAY, MD, INC.
Other - Org Name:CARIDAD C. AGDINAOAY, MD, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER/STATUTORY AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:AGDINAOAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-541-3333
Mailing Address - Street 1:13916 EUCLID AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-3822
Mailing Address - Country:US
Mailing Address - Phone:216-541-3333
Mailing Address - Fax:
Practice Address - Street 1:13916 EUCLID AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3822
Practice Address - Country:US
Practice Address - Phone:216-541-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0276893Medicaid
OHCA9331881Medicare UPIN