Organization
LAKE HEART CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJ P VALLABHANENI M.D. (PRESIDENT)
(440) 321-9725
Entity
Organization
Contact information
Practice address
124 LIBERTY ST, PAINESVILLE, OH 44077-3362
(440) 321-9725
Mailing address
124 LIBERTY ST, PAINESVILLE, OH 44077-3362
(440) 321-9725
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
05/09/2014
Last updated
04/28/2016
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