Provider Demographics
NPI:1760908644
Name:IRIZARRY, GABRIEL IGNACIO (BA IN SCIENCE)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:IGNACIO
Last Name:IRIZARRY
Suffix:
Gender:M
Credentials:BA IN SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 VIA DEL RIO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3371
Mailing Address - Country:US
Mailing Address - Phone:787-384-5283
Mailing Address - Fax:
Practice Address - Street 1:203 VIA DEL RIO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-384-5283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program