Provider Demographics
NPI:1821291642
Name:ARIZMENDI, ANGEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:L
Last Name:ARIZMENDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAYAMON MEDICAL PLAZA
Mailing Address - Street 2:CARR #2 1845 SUITE 505
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7204
Mailing Address - Country:US
Mailing Address - Phone:787-269-3015
Mailing Address - Fax:787-740-4720
Practice Address - Street 1:CARRETERA NUMERO 2
Practice Address - Street 2:BAYAMON MEDICAL PLAZA SUITE 505
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-269-3015
Practice Address - Fax:787-740-4720
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7704174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE43415Medicare UPIN