Provider Demographics
NPI:1871740738
Name:OCASIO, BIVIANA
Entity type:Individual
Prefix:
First Name:BIVIANA
Middle Name:
Last Name: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:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-1130
Mailing Address - Country:US
Mailing Address - Phone:787-248-9956
Mailing Address - Fax:787-871-3122
Practice Address - Street 1:CARR. 149 KM 9.8 BO. CAMPAMENTO
Practice Address - Street 2:SUITE 1
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638
Practice Address - Country:US
Practice Address - Phone:787-248-9956
Practice Address - Fax:787-871-3122
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7141183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician