Provider Demographics
NPI:1992364632
Name:RIZO HERNANDEZ, JESSICA IVELIZE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:IVELIZE
Last Name:RIZO HERNANDEZ
Suffix:
Gender:F
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:PO BOX 5000 PMB 534
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:787-466-0243
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 4055
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605-4055
Practice Address - Country:US
Practice Address - Phone:787-658-0000
Practice Address - Fax:787-819-0805
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15035-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice