Provider Demographics
NPI:1912311143
Name:IGLESIAS ESCABI, IVONNE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:IVONNE
Middle Name:MARIE
Last Name:IGLESIAS ESCABI
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:CONDOMINIO LADERAS DEL MAR 2481, PLAYUELAS, APT 505
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:939-218-6135
Mailing Address - Fax:
Practice Address - Street 1:MAYAGUEZ MEDICAL CENTER
Practice Address - Street 2:410 AVE HOSTOS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-652-9200
Practice Address - Fax:787-652-9222
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR31205R282N00000X
LA306467208000000X
PR217182080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty