Provider Demographics
NPI:1942341151
Name:ORAMA, LISPOLDO J (MD)
Entity Type:Individual
Prefix:DR
First Name:LISPOLDO
Middle Name:J
Last Name:ORAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LISPOLDO
Other - Middle Name:J
Other - Last Name:ORAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:LOOP 137 LAS VILLAS RAMEY
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-805-7550
Mailing Address - Fax:787-805-7570
Practice Address - Street 1:114 CALLE MCKINLEY W
Practice Address - Street 2:PLAZA YAGUEZ SUITE 205
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3874
Practice Address - Country:US
Practice Address - Phone:787-805-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8540173000000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E81914Medicare UPIN
0029749Medicare ID - Type Unspecified