Provider Demographics
NPI:1316361165
Name:RAFAEL A. OCASIO-SANTA , M.D.
Entity Type:Organization
Organization Name:RAFAEL A. OCASIO-SANTA , M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:OCASIO-SANTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-787-0003
Mailing Address - Street 1:PO BOX 363448
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3448
Mailing Address - Country:US
Mailing Address - Phone:787-787-0003
Mailing Address - Fax:787-787-0002
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:1845 CARR 2 STE 702
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7206
Practice Address - Country:US
Practice Address - Phone:787-787-0003
Practice Address - Fax:787-787-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10731207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR87805Medicare UPIN