Provider Demographics
NPI:1083817589
Name:RHEUMATOLOGISTS LLC
Entity Type:Organization
Organization Name:RHEUMATOLOGISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:ZEVALLOS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:440-899-4917
Mailing Address - Street 1:29099 HEALTH CAMPUS DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5200
Mailing Address - Country:US
Mailing Address - Phone:440-899-4917
Mailing Address - Fax:440-871-7940
Practice Address - Street 1:29099 HEALTH CAMPUS DR
Practice Address - Street 2:SUITE 350
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5200
Practice Address - Country:US
Practice Address - Phone:440-899-4917
Practice Address - Fax:440-871-7940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35100071207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0309544Medicaid
OH9912583Medicare ID - Type Unspecified
OH0309544Medicaid