Individual
DR. JOSE RAMON IRIZARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901
(407) 975-0406
(407) 975-0407
Mailing address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(407) 975-0406
(407) 975-0407
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
10561
PR
207V00000X
Obstetrics & Gynecology Physician
Primary
ME106787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002560700
—
FL
01
—
106787
ME FL LICENSE
FL
01
—
210561
MCS
PR
01
—
9070106
HUMANA
PR
Enumeration date
02/08/2006
Last updated
11/26/2019
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