Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jibaro Medical Clinic PLLC

Organization Internal Medicine Physician · NPI 1194734319

Jibaro Medical Clinic PLLC is an Internal Medicine Physician in Lakeside, Arizona. Licensed in Arizona. Registered with an NPI since 2006.

Licensed in
AZ
In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5658 Highway 260 Ste 19
Lakeside, AZ 85929-5189
Phone: (928) 532-5838
Fax: (928) 532-6670
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 24947 (AZ)

Record details

NPI number1194734319
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mirza Rivera — Owner · (923) 532-5838
NPI enumeratedAugust 5, 2006
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 1150, Show Low, AZ 85902-1150

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