1790604437 NPI number — KAMIRA N OSTOLAZA

Table of content: KAMIRA N OSTOLAZA (NPI 1790604437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790604437 NPI number — KAMIRA N OSTOLAZA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSTOLAZA
Provider First Name:
KAMIRA
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1790604437
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COOPERATIVA CIUDAD UNIVERSITARIA, AVENIDA PERIFERAL
Provider Second Line Business Mailing Address:
APARTAMENTO 807 B
Provider Business Mailing Address City Name:
TRUJILLO ALTO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-317-3868
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 CALLE BAEZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00917-5020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-767-6710
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2026

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: 103TC0700X , with the licence number:  9122 , 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)





Copyright © 2007-2026 www.npivalidator.com