Individual
LIZDANY CUELLO DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
12212 LARCHMERE BLVD, CLEVELAND, OH 44120-1102
(216) 507-3309
Mailing address
12212 LARCHMERE BLVD, CLEVELAND, OH 44120-1102
(216) 507-3309
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19-454
WI
Other
Enumeration date
01/22/2020
Last updated
03/16/2020
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