Provider Demographics
NPI:1578602629
Name:CABAN BADILLO, OSCAR (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:
Last Name:CABAN BADILLO
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 1:75 CALLE MERCADO
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-4931
Mailing Address - Country:US
Mailing Address - Phone:787-997-0694
Mailing Address - Fax:787-589-7262
Practice Address - Street 1:AVE VICTORIA 486
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-997-0694
Practice Address - Fax:787-997-0694
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11969207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H82131Medicare UPIN
PR89976Medicare ID - Type Unspecified