Provider Demographics
NPI:1750599148
Name:IRENE LOPEZ, ROSA MILAGROS
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:MILAGROS
Last Name:IRENE LOPEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GS 11 VIA 51 VILLA FONTANA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-4810
Mailing Address - Country:US
Mailing Address - Phone:787-602-2303
Mailing Address - Fax:
Practice Address - Street 1:22 AVE. WINSTON CHURCHILL
Practice Address - Street 2:SENORIAL PLAZA LOCAL E022
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00926-9998
Practice Address - Country:US
Practice Address - Phone:787-708-4997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR584235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist