Provider Demographics
NPI:1558750125
Name:NAZARIO IRIZARRY, LIZMARY (MD)
Entity Type:Individual
Prefix:
First Name:LIZMARY
Middle Name:
Last Name:NAZARIO 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:HC 1 BOX 7365
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-9066
Mailing Address - Country:US
Mailing Address - Phone:787-899-2373
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 7365
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-9066
Practice Address - Country:US
Practice Address - Phone:787-899-2373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18987208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice