Provider Demographics
NPI:1558515171
Name:OHIO VASCULAR ROBOTICS, INC.
Entity Type:Organization
Organization Name:OHIO VASCULAR ROBOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-291-3388
Mailing Address - Street 1:2109 HUGHES DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3856
Mailing Address - Country:US
Mailing Address - Phone:419-291-3388
Mailing Address - Fax:419-480-1253
Practice Address - Street 1:2109 HUGHES DR
Practice Address - Street 2:SUITE 800
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3856
Practice Address - Country:US
Practice Address - Phone:419-291-3388
Practice Address - Fax:419-480-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-03-9917M261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0372430Medicaid
OHBE0446254Medicare Oscar/Certification
OHC03759Medicare UPIN