Healthcare Provider Details

I. General information

NPI: 1598390262
Provider Name (Legal Business Name): EDILBERTO JOSE OCASIO FELICIANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY DISTRICT HOSPITAL PUERTO RICO MEDICAL CENTER
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

18 CALLE TAGORE APT 314
SAN JUAN PR
00926-4545
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-0101
  • Fax:
Mailing address:
  • Phone: 787-397-7738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number023688
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: