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General NPI Number Information
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NPI Number | 1790916104
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Entity Type | Organization
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Legal Business Name | EDWIN IRIZARRY RODRIGUEZ
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | HC 01 BOX 6168
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City | GUAYNABO
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State | PR
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Zip | 00971-0000
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Country | US
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Telephone | 787-239-5463
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Fax |
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Provider Business Mailing Address
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Address Line | CARR 833 KM 3.6 RAMAL 174 BO. GUARAGUAO
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City | GUAYNABO
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State | PR
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Zip | 00971-9541
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Country | US
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Telephone | 787-239-5463
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWIN IRIZARRY RODRIGUEZ
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Credential |
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Telephone | 787-239-5463
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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 | TCAMB 550
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License Number State | PR
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