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General NPI Number Information
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NPI Number | 1346508165
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Entity Type | Individual
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Provider Name | EMMANUEL ORLANDO GONZALEZ-IRIZARRY MD
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Gender | Male
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Dates
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Enumeration Date | 04/30/2012
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 564A CALLE JUAN J JIMENEZ
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City | SAN JUAN
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State | PR
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Zip | 00918-3722
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Country | US
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Telephone | 787-329-9105
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Fax | 787-545-6116
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Provider Business Mailing Address
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Address Line | 2332 COND LAGO PLAYA
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone |
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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 | 18675
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 18675
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License Number State | PR
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