Provider Demographics
NPI:1407323041
Name:CLEVELAND PHYSICIANS GROUP & SPA
Entity Type:Organization
Organization Name:CLEVELAND PHYSICIANS GROUP & SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIGMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:RINGOEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-790-1190
Mailing Address - Street 1:CLEVELAND PHYSICIANS GROUP & SPA
Mailing Address - Street 2:582 S.W. FLAGLER AVE.
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:32301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:582 SW FLAGLER AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2836
Practice Address - Country:US
Practice Address - Phone:954-790-1190
Practice Address - Fax:954-573-6514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty