Doctor Name: | DR. JOMARIE RIVERA IRIZARRY |
NPI Number: | 1922092758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 14978 |
Business Practice Address: | 7241 Marsh Ter Port Saint Lucie, FL - 349863232 |
Business Phone Number: | 7725795432 |
Business Fax Number: | |
Mailing Address: | 7241 Marsh Ter, PORT SAINT LUCIE |
State: | FL |
Postal Code: | 349863232 |
Phone Number: | 7725795432 |
Fax Number: | |
NPI Enumeration Date: | 09/08/2005 |
NPI Last Update Date: | 12/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14978 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |