Provider Demographics
NPI:1619961406
Name:KEY OYOLA, JOSE LUIS (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:LUIS
Last Name:KEY OYOLA
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 1:434 CALLE APENINOS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4127
Mailing Address - Country:US
Mailing Address - Phone:787-342-3555
Mailing Address - Fax:787-735-0043
Practice Address - Street 1:#3 DEGETAU AIBONITO PR
Practice Address - Street 2:AIBONITO OPTICAL
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-0043
Practice Address - Fax:787-735-0043
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR387152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR215907OtherPREFERRED HEALTH
PR59362OtherTRIPLE CCC
PR077034OtherCRUZAZUL
PR584193488OtherCIGNA
PR7050074OtherHUMANC
PRA317OtherFIRST MEDICAL
PR7050074OtherHUMANC
PR59362OtherTRIPLE CCC