Individual
DR. IRENE H BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17951 JEFFERSON PARK RD, CLEVELAND, OH 44130-8439
(440) 816-6414
(440) 816-6421
Mailing address
18181 PEARL RD, STRONGSVILLE, OH 44136-6949
(440) 816-6414
(440) 816-6421
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35048439B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0507624
—
OH
Enumeration date
06/07/2006
Last updated
03/23/2015
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