Provider Demographics
NPI:1750722781
Name:CARMONA RUBIO, ANDRES EDUARDO (MD)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:EDUARDO
Last Name:CARMONA RUBIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # J3-4
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0002
Mailing Address - Country:US
Mailing Address - Phone:216-445-5843
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # J3-4
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-3021
Practice Address - Country:US
Practice Address - Phone:216-445-5843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.140320207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program