Provider Demographics
NPI:1376711234
Name:GARCIA - IRIZARRY, LUIS ERNESTO (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ERNESTO
Last Name:GARCIA - IRIZARRY
Suffix:
Gender:M
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:RADIOLOGIA RCM
Mailing Address - Street 2:PO BOX 29134
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00935
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:787-777-3858
Practice Address - Street 1:ASEM - RADIOLOGIA 2DO PISO
Practice Address - Street 2:CENTRO MEDICO DE PUERTO RICO, BO. MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-777-3858
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0184932085R0202X
DC040569208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice