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General NPI Number Information
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NPI Number | 1750599148
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Entity Type | Individual
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Provider Name | ROSA MILAGROS IRENE LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 22 AVE. WINSTON CHURCHILL SENORIAL PLAZA LOCAL E022
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City | CAROLINA
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State | PR
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Zip | 00926-9998
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Country | US
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Telephone | 787-708-4997
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Fax |
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Provider Business Mailing Address
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Address Line | 4 GS 11 VIA 51 VILLA FONTANA
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City | CAROLINA
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State | PR
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Zip | 00983-4810
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Country | US
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Telephone | 787-602-2303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 584
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License Number State | PR
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