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Individual

JOCELYN BAUTISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(800) 223-2273
Mailing address
6000 W CREEK RD, SUITE 10, INDEPENDENCE, OH 44131-2139
(800) 223-2273

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35076747
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130023608
MEDICARE RAILROAD
OH
05
2259845
OH
Enumeration date
06/16/2006
Last updated
12/21/2007
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