Provider Demographics
NPI:1457557811
Name:IRIZARRY TOLEDO, EDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:
Last Name:IRIZARRY TOLEDO
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:HAC. DEL MONTE PASEO CONSTANCIA
Mailing Address - Street 2:5023
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-259-8420
Mailing Address - Fax:787-841-2818
Practice Address - Street 1:BUILDING PARRA 2225 PONCE BY PASS
Practice Address - Street 2:SUITE 103
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1320
Practice Address - Country:US
Practice Address - Phone:787-842-2478
Practice Address - Fax:787-841-2818
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12338174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist