MEDICARE: DR. PATRICIA E MATOS MOQUETE M.D.

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	208D00000X	General Practice Physician	16181	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16181	OTHER	PR	MEDICAL LICENSE

General Provider Information

NPI Number	:	1902872914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA E MATOS MOQUETE M.D.

Provider Business Mailing Address
First Line	:	604 CALLE MUNOZ RIVERA
Second Line	:
City	:	PENUELAS
State	:	PR
Zip	:	00624-1723
Country	:	US
Telephone Number	:	787-836-3409
Fax Number	:

Provider Business Practice Location Address
First Line	:	604 CALLE MUNOZ RIVERA
Second Line	:
City	:	PENUELAS
State	:	PR
Zip	:	00624-1709
Country	:	US
Telephone Number	:	787-836-3409
Fax Number	:

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	08/03/2024

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