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General NPI Number Information
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NPI Number | 1154534865
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Entity Type | Organization
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Legal Business Name | MORZAK HEALTH CARE SERVICES CSP
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | VALLE ARRIBA HEIGHTS AVE. FIDALGO DIAZ ESQ. AA5
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City | CAROLINA
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State | PR
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Zip | 00983-0000
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Country | US
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Telephone | 787-769-4034
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Fax | 787-768-8565
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Provider Business Mailing Address
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Address Line | P.O. BOX 9021
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City | CAROLINA
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State | PR
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Zip | 00988-0000
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Country | US
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Telephone | 787-769-4034
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Fax | 787-768-8565
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KHADIJAH A. HAMDALLAH
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Credential | M.D.
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Telephone | 787-769-4034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 11668
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License Number State | PR
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