Healthcare Provider Details

I. General information

NPI: 1437625134
Provider Name (Legal Business Name): ENOC MARTINEZ MORALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2018
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CERRO LAS MESAS, PR-349 KM. 2.7 HOSPITAL BELLA VISTA
MAYAGUEZ PUERTO RICO
00680
UM

IV. Provider business mailing address

HOSPITAL BELLA VISTA, CERRO LAS MESAS, PR-349 KM. 2.7
MAYAGUEZ PR
00680-8321
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-6000
  • Fax:
Mailing address:
  • Phone: 787-834-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24483
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: