Provider Demographics
NPI:1679604086
Name:IRIZARRY, YOLANDA
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:IRIZARRY
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 49001
Mailing Address - Street 2:PMB 113
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:787-201-8097
Mailing Address - Fax:
Practice Address - Street 1:FARMAUA SAN FELIPE CARR 129 15 BO BAYANEY
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-898-6378
Practice Address - Fax:787-898-6378
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002551183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician