Healthcare Provider Details

I. General information

NPI: 1588649719
Provider Name (Legal Business Name): MILAGROS LOPEZ-VELEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUANITA MILAGROS LOPEZ-VELEZ

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22750 ROCKSIDE RD
BEDFORD OH
44146-1574
US

IV. Provider business mailing address

PO BOX 5534
CAROL STREAM IL
60197-5534
US

V. Phone/Fax

Practice location:
  • Phone: 440-232-9800
  • Fax:
Mailing address:
  • Phone: 740-374-4500
  • Fax: 216-472-2740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-057508
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35.057508
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: