Healthcare Provider Details

I. General information

NPI: 1497433197
Provider Name (Legal Business Name): KELVIN L MORALES MILLAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 AVE MUNOZ RIVERA STE 602
SAN JUAN PR
00918-3629
US

IV. Provider business mailing address

602 AVE MUNOZ RIVERA STE 602
SAN JUAN PR
00918-3629
US

V. Phone/Fax

Practice location:
  • Phone: 787-557-3787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8209
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number8209
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: