Healthcare Provider Details

I. General information

NPI: 1548299852
Provider Name (Legal Business Name): HECTOR L MORALES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE CONCORDIA 8118 GALERIA PROFESIONAL OFC 107
PONCE PR
00717-1541
US

IV. Provider business mailing address

CALLE CONCORDIA 8118 GALERIA PROFESIONAL OFC 107
PONCE PR
00717-1541
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-4465
  • Fax:
Mailing address:
  • Phone: 787-843-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1677
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: