Provider Demographics
NPI:1881124410
Name:IRIZARRY CORTES, JOANNIE (OD)
Entity type:Individual
Prefix:DR
First Name:JOANNIE
Middle Name:
Last Name:IRIZARRY CORTES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 469
Mailing Address - Street 2:
Mailing Address - City:ANGELES
Mailing Address - State:PR
Mailing Address - Zip Code:00611
Mailing Address - Country:US
Mailing Address - Phone:787-394-0659
Mailing Address - Fax:
Practice Address - Street 1:200 CALLE RUIZ BELVIS
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-1724
Practice Address - Country:US
Practice Address - Phone:787-280-6986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR727152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist