Provider Demographics
NPI:1629728431
Name:OJEDA BONILLA, SOFIA VELISSE
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:VELISSE
Last Name:OJEDA BONILLA
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 1:1051 CALLE 3 SE
Mailing Address - Street 2:APT 809 COND. MEDICAL CENTER PLAZA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-600-3311
Mailing Address - Fax:
Practice Address - Street 1:1051 CALLE 3 SE
Practice Address - Street 2:APT 809 COND. MEDICAL CENTER PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-600-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program