Provider Demographics
NPI:1811943749
Name:CARDIOVASCULAR CONSULTANTS OF CLEVELAND INC
Entity type:Organization
Organization Name:CARDIOVASCULAR CONSULTANTS OF CLEVELAND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-942-5400
Mailing Address - Street 1:7200 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-7522
Mailing Address - Country:US
Mailing Address - Phone:440-942-5400
Mailing Address - Fax:440-942-9055
Practice Address - Street 1:7200 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-7522
Practice Address - Country:US
Practice Address - Phone:440-942-5400
Practice Address - Fax:440-942-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9306327Medicare PIN
OH9306326Medicare PIN
OH9237611Medicare PIN
OH9237617Medicare PIN
OH9361591Medicare PIN
OH9306323Medicare PIN
OH9306328Medicare PIN
OH9237619Medicare PIN
OH9306329Medicare PIN
OH9306325Medicare PIN