Provider Demographics
NPI:1417202680
Name:STRONGSVILLE PODIATRY LLC
Entity Type:Organization
Organization Name:STRONGSVILLE PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:E
Authorized Official - Last Name:VARGO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-816-4999
Mailing Address - Street 1:18181 PEARL RD
Mailing Address - Street 2:B-200
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-6949
Mailing Address - Country:US
Mailing Address - Phone:440-816-4999
Mailing Address - Fax:440-816-5973
Practice Address - Street 1:18181 PEARL RD
Practice Address - Street 2:B-200
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6949
Practice Address - Country:US
Practice Address - Phone:440-816-4999
Practice Address - Fax:440-816-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2252-V213ES0103X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty