1457564320 NPI number — MRS. YOLANDA OCASIO MARIN ADMINISTRATOR

Table of content: MRS. YOLANDA OCASIO MARIN ADMINISTRATOR (NPI 1457564320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457564320 NPI number — MRS. YOLANDA OCASIO MARIN ADMINISTRATOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OCASIO MARIN
Provider First Name:
YOLANDA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ADMINISTRATOR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457564320
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB.RAMIREZ #45 SAN JOSE ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CABO ROJO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-851-0767
Provider Business Mailing Address Fax Number:
787-851-0767

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WIPS THERAPEUTIC GROUP #70 RELAMPAGO ST.
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-833-2899
Provider Business Practice Location Address Fax Number:
787-833-2899
Provider Enumeration Date:
05/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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