Individual
DR. ROMEO SAPURIADA MICLAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1060 N ABBE RD, ELYRIA, OH 44035-1614
(440) 366-6215
(440) 366-6033
Mailing address
1060 N ABBE RD, ELYRIA, OH 44035-1614
(440) 366-6215
(440) 366-6033
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-038553
OH
207RN0300X
Nephrology Physician
Primary
35-038553
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2079656
—
OH
01
—
791111126
RAILROAD MEDICARE
OH
01
—
MI0432602
MEDICARE INDIVIDUAL PCAN
OH
Enumeration date
12/09/2005
Last updated
04/29/2024
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