Provider Demographics
NPI:1457561839
Name:QUILES OCASIO, MELBA L
Entity Type:Individual
Prefix:DR
First Name:MELBA
Middle Name:L
Last Name:QUILES 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:EDIFICIO MEDICO HERMANAS DAVILA CALLE B
Mailing Address - Street 2:ESQUINA JURB URB. HERMANAS DAVILA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-787-1314
Mailing Address - Fax:787-778-2323
Practice Address - Street 1:EDIFICIO MEDICO HERMANAS DAVILA CALLE B
Practice Address - Street 2:ESQUINA JURB URB. HERMANAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-787-1314
Practice Address - Fax:787-778-2323
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR950103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical