Provider Demographics
NPI:1639897846
Name:VERANOVA HEALTH
Entity Type:Organization
Organization Name:VERANOVA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKUBISIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-527-1070
Mailing Address - Street 1:21881 MARIAN CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2617
Mailing Address - Country:US
Mailing Address - Phone:440-527-1070
Mailing Address - Fax:216-502-4186
Practice Address - Street 1:7379 PEARL RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4898
Practice Address - Country:US
Practice Address - Phone:440-732-2173
Practice Address - Fax:216-502-4186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty