Provider Demographics
NPI:1740697986
Name:TAMAYO, NINA CARMELA ROSALES (DO, MS, MPH)
Entity type:Individual
Prefix:DR
First Name:NINA CARMELA
Middle Name:ROSALES
Last Name:TAMAYO
Suffix:
Gender:F
Credentials:DO, MS, MPH
Other - Prefix:
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Mailing Address - Street 1:11800 EDGEWATER DR APT 1016
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8551 DARROW RD
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2311
Practice Address - Country:US
Practice Address - Phone:330-486-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH01023382081P0004X
390200000X
OH34.0134572081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program