Provider Demographics
NPI:1053643742
Name:DR MAURO IRANZO GENERAL SURGEON PSC
Entity Type:Organization
Organization Name:DR MAURO IRANZO GENERAL SURGEON PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURO
Authorized Official - Middle Name:
Authorized Official - Last Name:IRANZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-645-4597
Mailing Address - Street 1:138 AVE WINSTON CHURCHILL
Mailing Address - Street 2:PMB 526
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DOCTORS' CENTER HOSPITAL STREET #2 KM. 47.7
Practice Address - Street 2:MEDICINA ESPECIALIZADA
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-8513
Practice Address - Country:US
Practice Address - Phone:787-621-3379
Practice Address - Fax:787-621-3319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty