Provider Demographics
NPI:1851703219
Name:NAZARIO-IRIZARRY, EMANUEL (MD)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:
Last Name:NAZARIO-IRIZARRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EMANUEL
Other - Middle Name:
Other - Last Name:NAZARIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3236 N POINCIANA BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4688
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3236 N POINCIANA BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-4688
Practice Address - Country:US
Practice Address - Phone:321-542-3786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130331207R00000X
TXR2183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine