Healthcare Provider Details

I. General information

NPI: 1942341151
Provider Name (Legal Business Name): LISPOLDO J ORAMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LISPOLDO J ORAMA MD

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 CALLE MCKINLEY W PLAZA YAGUEZ SUITE 205
MAYAGUEZ PR
00680-3874
US

IV. Provider business mailing address

LOOP 137 LAS VILLAS RAMEY
AGUADILLA PR
00603
US

V. Phone/Fax

Practice location:
  • Phone: 787-805-7550
  • Fax:
Mailing address:
  • Phone: 787-805-7550
  • Fax: 787-805-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number8540
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number8540
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: