MEDICARE: OIMOS PSC

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	231H00000X	Audiologist

General Provider Information

NPI Number	:	1649986845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OIMOS PSC

Provider Business Mailing Address
First Line	:	1813 BO ASOMANTE
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-2405
Country	:	US
Telephone Number	:	305-904-3649
Fax Number	:

Provider Business Practice Location Address
First Line	:	94 CALLE COLON
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-3115
Country	:	US
Telephone Number	:	305-904-3649
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ISMALY LORENZO MATIAS
Credential	:
Telephone Number	:	305-904-3649

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	01/31/2023

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Directions to “OIMOS PSC ” Practice Location

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