MEDICARE: EMANUEL NAZARIO-IRIZARRY M.D.

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	ME130331	FL
2	207R00000X	Internal Medicine Physician	R2183	TX

General Provider Information

NPI Number	:	1851703219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMANUEL NAZARIO-IRIZARRY M.D.

Provider Business Mailing Address
First Line	:	3236 N POINCIANA BLVD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-4688
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3236 N POINCIANA BLVD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-4688
Country	:	US
Telephone Number	:	321-542-3786
Fax Number	:

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

Provider Enumeration Date	:	05/20/2014
Last Update Date	:	05/09/2024

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