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Individual

LOLITA R AGRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3361 E 55TH ST, CLEVELAND, OH 44127-1547
(216) 441-0660
(216) 883-3335
Mailing address
3361 E 55TH ST, CLEVELAND, OH 44127-1547
(216) 441-0660
(216) 883-3335

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03354511
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0186758
OH
01
9926401
MEDICARE GROUP
OH
Enumeration date
11/15/2007
Last updated
12/04/2007
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