Provider Demographics
NPI:1104018175
Name:BEAUCHAMP-IRIZARRY, ANA G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:G
Last Name:BEAUCHAMP-IRIZARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7132
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7132
Mailing Address - Country:US
Mailing Address - Phone:787-306-2818
Mailing Address - Fax:787-813-0798
Practice Address - Street 1:1935 URB. SAN ANTONIO
Practice Address - Street 2:AVE. LAS AMERICAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1815
Practice Address - Country:US
Practice Address - Phone:787-306-2818
Practice Address - Fax:787-813-0798
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFL808AMedicare UPIN