Provider Demographics
NPI:1538157748
Name:OCASIO, MARIA T (OD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:OCASIO
Suffix:
Gender:F
Credentials:OD
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 1233
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-1233
Mailing Address - Country:US
Mailing Address - Phone:787-477-7534
Mailing Address - Fax:
Practice Address - Street 1:L56 AVE SANTA JUANITA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4635
Practice Address - Country:US
Practice Address - Phone:787-778-2957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR322152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005-6723Medicaid
PR005-6723Medicare ID - Type Unspecified
PR005-6723Medicaid