Healthcare Provider Details

I. General information

NPI: 1356541023
Provider Name (Legal Business Name): JOSE RAFAEL MORALES-RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 CALLE DR RAMON E BETANCES S
MAYAGUEZ PR
00680-1721
US

IV. Provider business mailing address

10916 OLDE WOODS WAY
COLUMBIA MD
21044-1000
US

V. Phone/Fax

Practice location:
  • Phone: 787-833-1868
  • Fax:
Mailing address:
  • Phone: 410-715-2328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number7925
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: