Provider Demographics
NPI:1992761803
Name:JOGLAR -IRIZARRY, FERNANDO LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:LUIS
Last Name:JOGLAR -IRIZARRY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:CIRUGIA TRAUMA RCM
Mailing Address - Street 2:PO BOX 29134
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-763-2440
Mailing Address - Fax:787-758-1119
Practice Address - Street 1:CLINICA DE LA ESCUELA DE MEDICINA
Practice Address - Street 2:REPARTO METROPOLITANO SHOPPING, AVE. AMERICO MIRANDA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-758-1119
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2017-03-08
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Provider Licenses
StateLicense IDTaxonomies
PR13,322208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI25159Medicare UPIN
PR2-2687Medicare PIN