Individual
DR. J. VICENTE P POBLETE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9500 EUCLID AVE, ECC1, CLEVELAND, OH 44195-0001
(440) 930-2572
Mailing address
9500 EUCLID AVE, ECC1, CLEVELAND, OH 44195-0001
(440) 930-2572
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
35068585
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0238693
—
OH
Enumeration date
04/03/2006
Last updated
11/02/2011
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