Healthcare Provider Details

I. General information

NPI: 1922075332
Provider Name (Legal Business Name): JOSE OSCAR MORALES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 ACEROLA ST. URB. MILAVILLE
SAN JUAN PR
00926
US

IV. Provider business mailing address

PO BOX 191922
SAN JUAN PR
00919-1922
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-2355
  • Fax: 787-763-1714
Mailing address:
  • Phone: 787-764-2355
  • Fax: 787-763-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2189
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number2189
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number2189
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: