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NPI Code Detail

MEDICARE: JENITZA IRIZARRY

MEDICARE: JENITZA IRIZARRY
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
1390200000XStudent in an Organized Health Care Education/Training ProgramPR

General Provider Information

NPI Number : 1518749274
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENITZA IRIZARRY
Provider Business Mailing Address
First Line : HC 2 BOX 8095
Second Line :
City : GUAYANILLA
State : PR
Zip : 00656-9734
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 997 CALLE SAN ROBERTO
Second Line :
City : SAN JUAN
State : PR
Zip : 00926-2759
Country : US
Telephone Number : 787-773-6508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2023
Last Update Date : 10/17/2023

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Directions to “ JENITZA IRIZARRY ” Practice Location

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