Provider Demographics
NPI:1851603724
Name:KUIZON, IRENE (DO)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:KUIZON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5224
Mailing Address - Country:US
Mailing Address - Phone:305-447-4150
Mailing Address - Fax:
Practice Address - Street 1:2121 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5224
Practice Address - Country:US
Practice Address - Phone:305-447-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11014207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine