Provider Demographics
NPI:1659657138
Name:OCASIO, MIGUEL A
Entity Type:Individual
Prefix:MR
First Name:MIGUEL
Middle Name:A
Last Name:OCASIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:F26 CALLE 1
Mailing Address - Street 2:MONTE SOL
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-3522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:F26 CALLE 1
Practice Address - Street 2:MONTE SOL
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3522
Practice Address - Country:US
Practice Address - Phone:787-730-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR033037164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse