Healthcare Provider Details

I. General information

NPI: 1568036028
Provider Name (Legal Business Name): LUZ MARIA OCASIO RIVERA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 05/18/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE F BF 21 URB VENUS GARDENS OESTE
SAN JUAN PR
00926
US

IV. Provider business mailing address

243 CALLE PARIS # 1153
SAN JUAN PR
00917-3632
US

V. Phone/Fax

Practice location:
  • Phone: 787-390-8342
  • Fax:
Mailing address:
  • Phone: 787-390-8342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3709
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: