Provider Demographics
NPI:1093976433
Name:JOSE R OYOLA MORALES
Entity Type:Organization
Organization Name:JOSE R OYOLA MORALES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:OYOLA MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-740-4364
Mailing Address - Street 1:226 CALLE COMERIO
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5358
Mailing Address - Country:US
Mailing Address - Phone:787-740-4364
Mailing Address - Fax:787-740-4364
Practice Address - Street 1:226 CALLE COMERIO
Practice Address - Street 2:SUITE 1
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5358
Practice Address - Country:US
Practice Address - Phone:787-740-4364
Practice Address - Fax:787-740-4364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8738261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care