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Individual

JOHANNA MAULORICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7330
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HTS, OH 44122-5203
(216) 286-6260
(216) 286-6341

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN217978
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221166
UNISON
OH
01
000000515997
ANTHEM
OH
01
0583328
BCMH
OH
05
2306034
OH
01
415008
WELLCARE MEDICAID
OH
01
430050956
RAILROAD MEDICARE
OH
01
750905
BUCKEYE MEDICAID
OH
01
7960351
AETNA
OH
01
P00405855
MEDICARE RAILROAD
OH
Enumeration date
07/28/2006
Last updated
05/19/2008
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