Provider Demographics
NPI:1558350371
Name:CIPRIAN-LIRANZO, PEDRO N (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:N
Last Name:CIPRIAN-LIRANZO
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:PO BOX 361540
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1540
Mailing Address - Country:US
Mailing Address - Phone:787-763-9500
Mailing Address - Fax:787-763-9260
Practice Address - Street 1:LALLE PADRE COLON # 275 RIO PIEDNAL
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:787-763-9500
Practice Address - Fax:787-763-9260
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14338208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H79755Medicare UPIN
PR0020991Medicare ID - Type Unspecified