Provider Demographics
NPI:1124735998
Name:DR OSVALDO DARIO BAZIL MIESES MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:DR OSVALDO DARIO BAZIL MIESES MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:OSVALDO
Authorized Official - Middle Name:DARIO
Authorized Official - Last Name:BAZIL-MIESES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-329-7814
Mailing Address - Street 1:URB VISTA VERDE CALLE CORAL # 6
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COND. MEDICAL PLAZA 740 AVE HOSTOS SUITE 314
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:915-329-7814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty