Provider Demographics
NPI:1215415989
Name:GARCIA IRIZARRY, KIMBERLY DENISSE (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DENISSE
Last Name:GARCIA IRIZARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-967-6400
Mailing Address - Fax:
Practice Address - Street 1:4972 TOWN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8595
Practice Address - Country:US
Practice Address - Phone:904-642-6100
Practice Address - Fax:904-642-5154
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME174425208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics