Healthcare Provider Details

I. General information

NPI: 1043710171
Provider Name (Legal Business Name): ARELIS NICOLE MORALES MALAVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 11/02/2024
Certification Date: 11/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 CALLE 62 SE
SAN JUAN PR
00921
US

IV. Provider business mailing address

3J39 CALLE 32 TERRAZAS DEL TOA
TOA ALTA PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone: 787-427-8877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number23199
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: