Healthcare Provider Details

I. General information

NPI: 1972758134
Provider Name (Legal Business Name): NADYA MILAGROS MORALES LEBRON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CARR 696
DORADO PR
00646-5718
US

IV. Provider business mailing address

1527 AVE. PONCE DE LEON SECTOR 5 STE. 105
SAN JUAN PUERTO RICO
00926
UM

V. Phone/Fax

Practice location:
  • Phone: 787-625-5050
  • Fax:
Mailing address:
  • Phone: 787-674-1272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number16287
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: