Provider Demographics
NPI:1790837904
Name:RECINOS, VIOLETTE MATHILDE RENARD (MD)
Entity Type:Individual
Prefix:DR
First Name:VIOLETTE
Middle Name:MATHILDE RENARD
Last Name:RECINOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VIOLETTE
Other - Middle Name:MATHILDE
Other - Last Name:RENARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:S60
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-4549
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-4549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35095008207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3031552Medicaid
OH7411151Medicare PIN