Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 15554 | PR |
N | 207QA0401X | Family Doctor - Addiction Medicine | 15554 | PR |
Y | 208D00000X | General Practice Physician | 15554 | PR |
NPI | 1871585265 |
---|---|
Provider Name | Dr. Saul Irizarry Vazquez |
First Address | Yauco, PR 00698-9608 |
Second Address | Yauco, PR 00698-9608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 05/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I28941 | (02) | PR |