Individual
MARSHA J BORTMAS PANTALONE
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
(216) 844-3781
Mailing address
3605 WARRENSVILLE CENTER ROAD, 1ST FLOOR, SHAKER HTS, OH 44122
(216) 286-6260
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN225715
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221293
UNISON
OH
01
—
000000515984
ANTHEM
OH
01
—
0583328
BCMH
OH
05
—
2463838
—
OH
01
—
415017
WELLCARE MEDICAID
OH
01
—
430026421
RAILROAD MEDICARE
OH
01
—
751175
BUCKEYE MEDICAID
OH
01
—
9067058
AETNA
OH
01
—
P00678090
MEDICARE RAILROAD
OH
Enumeration date
07/28/2006
Last updated
04/14/2009
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