Provider Demographics
NPI:1003189036
Name:IRIZARRY FEBRES, MARIAN GIOVANI (MD)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:GIOVANI
Last Name:IRIZARRY FEBRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23532 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-6753
Mailing Address - Country:US
Mailing Address - Phone:813-909-1600
Mailing Address - Fax:813-909-1005
Practice Address - Street 1:23532 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-6753
Practice Address - Country:US
Practice Address - Phone:813-909-1600
Practice Address - Fax:813-909-1005
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116480207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107362900Medicaid