Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 287025 | NY |
Y | 2080P0205X | Pediatric Endocrinologist | ME140768 | FL |
NPI | 1427291046 |
---|---|
Provider Name | Krystal Andrea Irizarry |
First Address | Winter Park, FL 32789-2167 |
Second Address | Winter Park, FL 32789-2167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2009 |
Last Update Date | 16/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04698688 | (05) | NY |