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General NPI Number Information
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NPI Number | 1093841348
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Entity Type | Organization
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Legal Business Name | J. MICHAEL VENTO, M.D.
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 34600 CHARDON RD BUILDING 3
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City | WILLOUGHBY
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State | OH
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Zip | 44094-8480
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Country | US
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Telephone | 440-460-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 34600 CHARDON RD BUILDING 3
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City | WILLOUGHBY
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State | OH
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Zip | 44094-8480
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Country | US
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Telephone | 440-460-2828
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. J. MICHAEL VENTO
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Credential | M.D.
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Telephone | 440-460-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 35052241
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 35052241
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License Number State | OH
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