Healthcare Provider Details

I. General information

NPI: 1629766027
Provider Name (Legal Business Name): HAROLD LOUIS ZAYAS MORALES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CALLE JOSE I QUINTON
COAMO PR
00769-2408
US

IV. Provider business mailing address

PO BOX 363043
SAN JUAN PR
00936-3043
US

V. Phone/Fax

Practice location:
  • Phone: 787-803-4773
  • Fax:
Mailing address:
  • Phone: 787-725-7999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number917
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: