# IIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538844782
- **Authorized official:** IDALIA IRIZARRY-CASTILLO RDN, LND, MHSN (PRESIDENT)
- **Authorized official phone:** (787) 831-5831

## Contact information

- **Practice address:** 351 AVE HOSTOS STE 205, MAYAGUEZ, PR 00680-1503
- **Practice address phone:** (787) 831-5831
- **Mailing address:** HC 1 BOX 6100, GUAYANILLA, PR 00656-9444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/15/2023
- **Last updated:** 06/15/2023