Provider Demographics
NPI:1083137533
Name:OCASIO MELENDEZ, JOSE JUAN (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:JUAN
Last Name:OCASIO MELENDEZ
Suffix:
Gender:M
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:PO BOX 1412
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-1412
Mailing Address - Country:US
Mailing Address - Phone:787-642-6165
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 173
Practice Address - Street 2:HOSPITAL DE LA CONCEPCION
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19726208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice