Provider Demographics
NPI:1477634913
Name:OCASIO, JAVIER (OD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:OCASIO
Suffix:
Gender:M
Credentials:OD
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 142565
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-2565
Mailing Address - Country:US
Mailing Address - Phone:787-878-9079
Mailing Address - Fax:787-881-0046
Practice Address - Street 1:1208 AVE MIRAMAR
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-2763
Practice Address - Country:US
Practice Address - Phone:787-878-9079
Practice Address - Fax:787-881-9079
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR388152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR58150Medicare ID - Type Unspecified