Organization
IIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDALIA IRIZARRY-CASTILLO RDN, LND, MHSN (PRESIDENT)
(787) 831-5831
Entity
Organization
Contact information
Practice address
351 AVE HOSTOS STE 205, MAYAGUEZ, PR 00680-1503
(787) 831-5831
Mailing address
HC 1 BOX 6100, GUAYANILLA, PR 00656-9444
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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