Healthcare Provider Details

I. General information

NPI: 1013827955
Provider Name (Legal Business Name): EO NEPHRO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 653 KM 0.5 TORRE MEDICA VILLA LOS SANTOS, SUITE 404
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 945
QUEBRADILLAS PR
00678-0945
US

V. Phone/Fax

Practice location:
  • Phone: 787-879-1585
  • Fax:
Mailing address:
  • Phone: 787-397-7738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: EDILBERTO OCASIO FELICIANO
Title or Position: OWNER
Credential: M.D.
Phone: 787-397-7738