Healthcare Provider Details

I. General information

NPI: 1245205814
Provider Name (Legal Business Name): MARIA ISABEL MORALES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE GUARUAO 145 MONTEHIEDRA
SAN JUAN PR
00926
US

IV. Provider business mailing address

PO BOX 2500
TRUJILLO ALTO PR
00977-2500
US

V. Phone/Fax

Practice location:
  • Phone: 787-760-6604
  • Fax: 787-292-0130
Mailing address:
  • Phone: 787-760-6604
  • Fax: 787-292-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6890
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: