Provider Demographics
NPI:1720058142
Name:IRIZARRY, CESAR OCTAVIO (DC)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:OCTAVIO
Last Name:IRIZARRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 S OBT
Mailing Address - Street 2:STE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5735
Mailing Address - Country:US
Mailing Address - Phone:407-219-4966
Mailing Address - Fax:
Practice Address - Street 1:6900 S OBT
Practice Address - Street 2:STE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5735
Practice Address - Country:US
Practice Address - Phone:407-219-4966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor