Healthcare Provider Details

I. General information

NPI: 1770938045
Provider Name (Legal Business Name): CRISTINA MARIA NUNEZ MORALES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DOMENECH 400 SUITE 413
SAN JUAN PR
00918
US

IV. Provider business mailing address

BARRIO MONACILLOS CARRETERA 22 CENTRO MEDICO PR HOSPITAL PEDIATRICO UNIVERSITARIO DR ANTONIO ORTIZ
SAN JUAN PR
00935-0001
US

V. Phone/Fax

Practice location:
  • Phone: 787-753-7586
  • Fax:
Mailing address:
  • Phone: 787-753-6390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33125
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33811
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number21248
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: