Provider Demographics
NPI:1720372485
Name:IRIZARRY HERNANDEZ, WILMIRIS (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:WILMIRIS
Middle Name:
Last Name:IRIZARRY HERNANDEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 CALLE MIGUEL CERVANTES
Mailing Address - Street 2:MANSIONES DE ESPANA
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6638
Mailing Address - Country:US
Mailing Address - Phone:787-407-2232
Mailing Address - Fax:
Practice Address - Street 1:241 CALLE MIGUEL CERVANTES
Practice Address - Street 2:MANSIONES DE ESPANA
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6638
Practice Address - Country:US
Practice Address - Phone:787-407-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist