Individual provider Active NPI

Ozema M. Mirabal, M.D.

  • Specialist
  • San Juan, PR
National Provider Identifier
1275614323
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4734 Issued in PR
Practice address
200 Ave Jesus T Pinero
Condominio Hato Rey Plaza, 17L
San Juan, PR 00918-4109
Phone
(787) 754-2018
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4734 PR Primary

Addresses

Primary practice location

200 Ave Jesus T Pinero
Condominio Hato Rey Plaza, 17L
San Juan, PR 00918-4109

Mailing address

200 Ave Jesus T Pinero
Condominio Hato Rey Plaza, 17L
San Juan, PR 00918-4109
Phone (787) 754-2018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4734PRMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275614323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AVE JESUS T PINERO",
            "address_2": "CONDOMINIO HATO REY PLAZA, 17L",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184109",
            "telephone_number": "787-754-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVE JESUS T PINERO",
            "address_2": "CONDOMINIO HATO REY PLAZA, 17L",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184109",
            "telephone_number": "787-754-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRABAL",
        "first_name": "OZEMA",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "4734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.