Healthcare Provider Details

I. General information

NPI: 1992099832
Provider Name (Legal Business Name): WILLIAM MORALES RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 AVE MARUCA
PONCE PR
00728-4103
US

IV. Provider business mailing address

MIGUEL RIVERA STREET NUMBER 123
PONCE PR
00730
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-5978
  • Fax: 787-812-5966
Mailing address:
  • Phone: 787-298-2223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4457
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: