Matos-Cruz, Mario

Matos-Cruz, Mario is an individual health care provider with primary practice located at 830 W High St Ste 207 , Lima OH 45801-3975. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Matos-Cruz, Mario can be contacted via phone (419) 996-4011.

Contact Information

Primary practice address
830 W High St Ste 207 Lima OH 45801-3975
Phone: (419) 996-4011
Fax: (419) 996-4012
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 35065706 Ohio

Profile Details

NPI number 1588868616
LBN Legal business name Matos-Cruz, Mario
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2007
Last updated Dec 9th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588868616 NPPES
Ohio MEDICAID 0065177
Ohio MEDICAID 20010800A

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