Healthcare Provider Details
I. General information
NPI: 1811880131
Provider Name (Legal Business Name): MOANES MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1845 CARR 2 BAYAMON MEDICAL PLAZA SUITE 805
BAYAMON PR
00959
US
IV. Provider business mailing address
104 CALLE REINA CATALINA
GUAYNABO PR
00969-3274
US
V. Phone/Fax
- Phone: 787-740-5060
- Fax:
- Phone: 787-607-7677
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LUIS
M
TORRES
Title or Position: PRESIDENTE
Credential: DPM
Phone: 787-607-7677