Organization
FORTALEZA,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY VILLA SR. (PRESIDENT)
(440) 324-7406
Entity
Organization
Contact information
Practice address
6061 S BROADWAY, LORAIN, OH 44053-3818
(440) 375-5342
Mailing address
6061 S BROADWAY, LORAIN, OH 44053-3818
(440) 375-5342
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
09/21/2017
Last updated
04/24/2026
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