Basic Information
| Provider Information | |||||||||
| NPI: | 1477901841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IRIZARRY DE JESUS | ||||||||
| FirstName: | DARIEL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 126 EXT VILLA MILAGROS | ||||||||
| Address2: | |||||||||
| City: | CABO ROJO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006234453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875383488 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2225 PONCE BYP STE 407 | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007171322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878408686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2016 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 22663 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.