Provider Demographics
NPI:1447090618
Name:CANDELARIO-OCASIO, KAREN JUSTINA
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JUSTINA
Last Name:CANDELARIO-OCASIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 CALLE LOS MANGOS
Mailing Address - Street 2:
Mailing Address - City:SABANA SECA
Mailing Address - State:PR
Mailing Address - Zip Code:00952-4147
Mailing Address - Country:US
Mailing Address - Phone:787-224-5495
Mailing Address - Fax:
Practice Address - Street 1:P.O BOX 1143
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-868-1752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1943363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical