Healthcare Provider Details

I. General information

NPI: 1942135298
Provider Name (Legal Business Name): MARLON MORALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 CALLE ESTRELLA DEL MAR
JUANA DIAZ PR
00795-9526
US

IV. Provider business mailing address

510 CALLE ESTRELLA DEL MAR
JUANA DIAZ PR
00795-9526
US

V. Phone/Fax

Practice location:
  • Phone: 787-246-4717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6826
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: