Organization · NPI-2
Cleveland Orthopedic And Spine Institute, LLC
Clinic/Center · Mayfield Heights, OH
NPI number1033988928
StatusActive
Last updated in NPPESApr 14, 2025
Details
- NPI
- 1033988928
- Entity type
- Organization (NPI-2)
- Legal business name
- Cleveland Orthopedic And Spine Institute, LLC
- Organization subpart
- Yes
- Enumeration date
- Dec 20, 2023
- Certification date
- Apr 14, 2025
- Last updated
- Apr 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 207L00000X | Anesthesiology | – | – | |
| 207X00000X | Orthopaedic Surgery | – | – | |
| 261QP2000X | Clinic/Center, Physical Therapy | – | – | |
| 261QR0200X | Clinic/Center, Radiology | – | – | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Mark R. Grubb, MD, INC (Former Legal Business Name)
Practice location
300 Allen Bradley Dr Ste 200Mayfield Heights, OH 44124-6130
Phone 844-746-8537
Mailing address
300 Allen Bradley Dr Ste 200Mayfield Heights, OH 44124-6130
Phone 407-307-7652
Authorized official
Mary Ebert
Compliance Officer
6142602357
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