MEDICARE: OSVALDO D BAZIL MD PA PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1265390058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSVALDO D BAZIL MD PA PC

Provider Business Mailing Address
First Line	:	URB VISTA VERDE #6 CALLE CORAL
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-2508
Country	:	US
Telephone Number	:	915-329-7814
Fax Number	:	939-935-9006

Provider Business Practice Location Address
First Line	:	MEDICAL CENTER PLAZA 740 AVE. EUGENIO MARIA DE HOSTOS
Second Line	:	SUITE 314
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1541
Country	:	US
Telephone Number	:	939-935-9238
Fax Number	:	939-935-9006

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. OSVALDO D. BAZIL-MIESES
Credential	:	MD
Telephone Number	:	915-329-7814

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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