Healthcare Provider Details

I. General information

NPI: 1497724827
Provider Name (Legal Business Name): ELENA MOCOROA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL DR. CAYETANO COLL Y TOSTE, CARR. #129, KM. 1 AVENIDA SAN LUIS, SUITE #120
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 9576 COTTO STATION
ARECIBO PR
00613-9576
US

V. Phone/Fax

Practice location:
  • Phone: 787-878-3501
  • Fax: 787-880-7232
Mailing address:
  • Phone: 787-878-3501
  • Fax: 787-880-7232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4959
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: