Fortaleza,llc

NPI #1427567445 in Elyria, Ohio

Provider Information

NPI Number: 1427567445
Entity Type: Organization
Organization Name: Fortaleza,llc
Primary Specialty: General Practice
Enumeration Date: Sep 21, 2017
Last Updated: Mar 17, 2018

Practice Location

Address: 41641 N RIDGE RD STE B
City: Elyria
State: Ohio
ZIP Code: 44035-1264
Phone: (440) 324-7406

Authorized Official

Name: ANTHONY VILLA SR.
Title: PRESIDENT
Phone: (440) 324-7406

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychiatry & Neurology - Addiction Medicine — Addiction Medicine	2084A0401X
Family Medicine	207Q00000X
Family Medicine - Addiction Medicine — Addiction Medicine	207QA0401X
Internal Medicine	207R00000X
Internal Medicine - Addiction Medicine — Addiction Medicine	207RA0401X
Clinical Medical Laboratory	291U00000X
General Practice	208D00000X	Primary

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