| Doctor Name: | DR. MANRIQUE OSCAR IRIARTE |
| NPI Number: | 1003096587 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 9102504 |
| Business Practice Address: | 9019 Pines Blvd Pembroke Pines, FL - 330246440 |
| Business Phone Number: | 9544384000 |
| Business Fax Number: | |
| Mailing Address: | 6801 Sw 147th Ave Apt 2d, MIAMI |
| State: | FL |
| Postal Code: | 331931018 |
| Phone Number: | 3057814815 |
| Fax Number: | |
| NPI Enumeration Date: | 11/13/2007 |
| NPI Last Update Date: | 07/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 9102504 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |