MEDICARE: DR. J MICHAEL VENTO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	35052241	OH
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	35052241	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568472371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. J MICHAEL VENTO M.D.

Provider Business Mailing Address
First Line	:	125 HUNTING TRL
Second Line	:
City	:	MORELAND HILLS
State	:	OH
Zip	:	44022-2546
Country	:	US
Telephone Number	:	440-943-5936
Fax Number	:	440-943-5806

Provider Business Practice Location Address
First Line	:	34600 CHARDON RD
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-8480
Country	:	US
Telephone Number	:	440-943-5936
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	05/22/2008

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