Provider Demographics
NPI:1699314906
Name:FOJO, YOMAIRA M
Entity type:Individual
Prefix:
First Name:YOMAIRA
Middle Name:M
Last Name:FOJO
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:ISLOTE 2 CASA 242 CALLE 11
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE TOMAS DAVILA
Practice Address - Street 2:EDIFICIO TMG MEDICAL
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-0061
Practice Address - Country:US
Practice Address - Phone:787-309-5569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR731156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician