Provider Demographics
NPI:1346684099
Name:VALLE IRIZARRY, ISMAEL J (MD)
Entity Type:Individual
Prefix:
First Name:ISMAEL
Middle Name:J
Last Name:VALLE IRIZARRY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:197 AVE TITO CASTRO HOSPITAL SAN LUCAS
Mailing Address - Street 2:CLINICAS EXTERNA MULTIDISCIPLINARIA PISO G
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733
Mailing Address - Country:US
Mailing Address - Phone:939-638-2919
Mailing Address - Fax:
Practice Address - Street 1:CENTRO MEDICO EPISCOPAL SAN LUCAS AVE. TITO CASTRO 917
Practice Address - Street 2:CLINICAS EXTERNA DISCIPLINARIA, LOBBY C
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:939-638-2919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2022-07-12
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Provider Licenses
StateLicense IDTaxonomies
PR19354174400000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No174400000XOther Service ProvidersSpecialist