Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME116904 | FL |
Y | 111NI0900X | Internist | ME116904 | FL |
NPI | 1003096587 |
---|---|
Provider Name | Dr. Manrique Oscar Iriarte |
First Address | Miami, FL 33193-1018 |
Second Address | Pembroke Pines, FL 33024-6440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2007 |
Last Update Date | 26/07/2013 |