Provider Demographics
NPI:1578776092
Name:OCASIO, KATY HAIDELIS
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:HAIDELIS
Last Name:OCASIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 6630
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-9707
Mailing Address - Country:US
Mailing Address - Phone:787-214-3595
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 6630
Practice Address - Street 2:
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720-9707
Practice Address - Country:US
Practice Address - Phone:787-214-3595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3879183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician