MEDICARE: DR. ANA G BEAUCHAMP-IRIZARRY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	17948	PR

General Provider Information

NPI Number	:	1104018175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA G BEAUCHAMP-IRIZARRY MD

Provider Business Mailing Address
First Line	:	PO BOX 7132
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-7132
Country	:	US
Telephone Number	:	787-306-2818
Fax Number	:	787-813-0798

Provider Business Practice Location Address
First Line	:	1935 URB. SAN ANTONIO
Second Line	:	AVE. LAS AMERICAS
City	:	PONCE
State	:	PR
Zip	:	00728-1815
Country	:	US
Telephone Number	:	787-306-2818
Fax Number	:	787-813-0798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	09/29/2016

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