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General NPI Number Information
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NPI Number | 1861439093
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Entity Type | Individual
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Provider Name | TERESA C IRIBARREN MD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 12955 SW 42ND ST SUITE 12
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City | MIAMI
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State | FL
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Zip | 33175-2902
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Country | US
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Telephone | 305-226-5106
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Fax | 305-226-5105
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Provider Business Mailing Address
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Address Line | 12955 SW 42ND ST SUITE 12
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City | MIAMI
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State | FL
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Zip | 33175-2902
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Country | US
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Telephone | 305-226-5106
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Fax | 305-226-5105
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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 | 79837
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License Number State | FL
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