MEDICARE: DR. PEDRO MORALES-HERNANDEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	6609	PR

General Provider Information

NPI Number	:	1508843764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO MORALES-HERNANDEZ MD

Provider Business Mailing Address
First Line	:	59 CALLE SANTA ANA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1450
Country	:	US
Telephone Number	:	787-760-0892
Fax Number	:	787-760-0892

Provider Business Practice Location Address
First Line	:	59 CALLE SANTA ANASTACIA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4262
Country	:	US
Telephone Number	:	787-760-0892
Fax Number	:	787-760-0892

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	07/08/2007

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