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General NPI Number Information
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NPI Number | 1679890875
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Entity Type | Organization
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Legal Business Name | ANGEL NIEVES IRIZARRY
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 11/25/2013
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Provider Practice Location Address
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Address Line | 4236 CALLE GARDEL URB BALDORIOTY
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City | PONCE
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State | PR
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Zip | 00728-2892
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Country | US
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Telephone | 787-372-1505
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Fax | 787-200-8117
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Provider Business Mailing Address
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Address Line | 4236 CALLE GARDEL URB BALDORIOTY
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City | PONCE
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State | PR
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Zip | 00728-2892
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Country | US
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Telephone | 787-372-1505
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Fax | 787-200-8117
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Authorized Official
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Title or Position | DUENO
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Name | ANGEL NIEVES IRIZARRY
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Credential |
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Telephone | 787-372-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2672 CP
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License Number State | PR
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