| Organization Name: | DORAMED MEDICAL OFFICE |
| NPI Number: | 1093031049 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ODELSA M DIAZ (DOCTOR IN MEDICINE/PRESIDENT) |
| Mailing Address: | Carr. 165 Km 4.0 Bo. Quebrada Cruz Toa Alta |
| State: | PR US |
| Postal Code: | 00953 |
| Phone Number: | 7878702938 |
| Fax Number: | 7878702938 |
| NPI Enumeration Date: | 04/15/2010 |
| NPI Last Update Date: | 04/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |