Provider Demographics
NPI:1932255064
Name:DOPAZO, IRMA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:MARIA
Last Name:DOPAZO
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:CAMINO CEDROS #61
Mailing Address - Street 2:URB. SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-703-1369
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA DEGETAU # A17
Practice Address - Street 2:CORPORACION PUERTORRIQUENA DE SALUD
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-743-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10739208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics