Provider Demographics
NPI:1699857805
Name:IRIZARRY RAMOS, LUZ E (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:E
Last Name:IRIZARRY RAMOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 COND AVENTURA
Mailing Address - Street 2:ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-257-8967
Mailing Address - Fax:
Practice Address - Street 1:66 CARR 848 ESQ FLORENTINO PLAZA 2DO PISO OFIC 1 A
Practice Address - Street 2:VILLA SAN ANTON
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-6857
Practice Address - Country:US
Practice Address - Phone:787-257-8967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001717103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical