Provider Demographics
NPI:1598865065
Name:ARZUAGA GONZALEZ, IRIS JANET
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:JANET
Last Name:ARZUAGA GONZALEZ
Suffix:
Gender:F
Credentials:
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 1262
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1262
Mailing Address - Country:US
Mailing Address - Phone:787-922-9449
Mailing Address - Fax:787-793-5656
Practice Address - Street 1:772 AVE SAN PATRICIO
Practice Address - Street 2:URB LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-210-7628
Practice Address - Fax:787-793-5656
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14077208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH73779Medicare UPIN