Provider Demographics
NPI:1093989238
Name:IRIZARRY, YOMARIE (MD)
Entity Type:Individual
Prefix:
First Name:YOMARIE
Middle Name:
Last Name:IRIZARRY
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 1:13795 SW 147TH CIRCLE LN
Mailing Address - Street 2:COUNTRY WALK APT.4
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8231
Mailing Address - Country:US
Mailing Address - Phone:786-214-0342
Mailing Address - Fax:
Practice Address - Street 1:13795 SW 147TH CIRCLE LN
Practice Address - Street 2:COUNTRY WALK APT.4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-8231
Practice Address - Country:US
Practice Address - Phone:786-214-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR016989208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice