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General NPI Number Information
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NPI Number | 1003096587
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Entity Type | Individual
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Provider Name | MANRIQUE OSCAR IRIARTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 800 GOODLETTE RD STE 200
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City | NAPLES
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State | FL
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Zip | 34102-5408
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Country | US
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Telephone | 239-302-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 429 NW 130TH AVE
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City | MIAMI
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State | FL
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Zip | 33182-1143
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Country | US
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Telephone | 305-781-4815
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME116904
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License Number State | FL
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