Healthcare Provider Details

I. General information

NPI: 1619297942
Provider Name (Legal Business Name): LISANDRA MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: THERAPY SERVICES SOLUTIONS R.T.

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13-13 CALLE 54 ROYAL TOWN
BAYAMON PR
00956-4505
US

IV. Provider business mailing address

13-13 CALLE 54 ROYAL TOWN
BAYAMON PR
00956-4505
US

V. Phone/Fax

Practice location:
  • Phone: 787-923-4085
  • Fax:
Mailing address:
  • Phone: 787-923-4085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number2091
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: