Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 8584 | PR |
NPI | 1164439857 |
---|---|
Provider Name | Dr. Alfredo Irizarri |
First Address | Guayanilla, PR 00656-0062 |
Second Address | Guayanilla, PR 00656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |