Provider Demographics
NPI:1174748719
Name:IRIZARRY, IVONNE RAMOS (BA)
Entity type:Individual
Prefix:MRS
First Name:IVONNE
Middle Name:RAMOS
Last Name:IRIZARRY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE PROGRESO #149
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-366-7131
Mailing Address - Fax:
Practice Address - Street 1:AVE HOSTOS 410
Practice Address - Street 2:SUITE #1
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1522
Practice Address - Country:US
Practice Address - Phone:787-832-7355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PROTL831225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist