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NPI Code Detail

MEDICARE: MARISELLY MEDINA-IRIZARRY MD

MEDICARE:   MARISELLY  MEDINA-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
1207RP1001XPulmonary Disease PhysicianME93134FL
2207RS0012XSleep Medicine (Internal Medicine) PhysicianME93134FL
3207RC0200XCritical Care Medicine (Internal Medicine) PhysicianME93134FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1U5089WOTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144209669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISELLY MEDINA-IRIZARRY MD
Provider Business Mailing Address
First Line : 8803 FUTURES DR STE 7
Second Line :
City : ORLANDO
State : FL
Zip : 32819-9076
Country : US
Telephone Number : 407-219-5936
Fax Number : 407-480-3455
Provider Business Practice Location Address
First Line : 8803 FUTURES DR STE 7
Second Line :
City : ORLANDO
State : FL
Zip : 32819-9076
Country : US
Telephone Number : 407-219-5936
Fax Number : 407-480-3455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2006
Last Update Date : 02/10/2012

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Directions to “ MARISELLY MEDINA-IRIZARRY MD” Practice Location

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