Healthcare Provider Details

I. General information

NPI: 1295990489
Provider Name (Legal Business Name): YIAMIRA SONALIS OQUENDO-OCASIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UPR MEDICAL SCIENCES CAMPUS SUITE 209
SAN JUAN PR
00936-0936
US

IV. Provider business mailing address

P17 LUZ OESTE LEVITTOWN LAKES
TOA BAJA PR
00949-4959
US

V. Phone/Fax

Practice location:
  • Phone: 787-756-4020
  • Fax:
Mailing address:
  • Phone: 787-585-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18121
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: