Provider Demographics
NPI:1578687687
Name:GERIATRIC PROVIDERS AND HOSPITALISTS INC
Entity Type:Organization
Organization Name:GERIATRIC PROVIDERS AND HOSPITALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEITES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-745-9320
Mailing Address - Street 1:PO BOX 645369
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-5369
Mailing Address - Country:US
Mailing Address - Phone:859-291-4800
Mailing Address - Fax:
Practice Address - Street 1:10999 REED HARTMAN HWY
Practice Address - Street 2:SUITE 215
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-8301
Practice Address - Country:US
Practice Address - Phone:513-745-9320
Practice Address - Fax:513-745-9324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2451814Medicaid
OH9338201Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER