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General NPI Number Information
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NPI Number | 1225438286
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Entity Type | Organization
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Legal Business Name | JOSE N. MORENO, M.D., C.S.P.
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 1 CALLE SANTA CRUZ, OFICINA 605,
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City | TORRE SAN PABLO
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State | PR
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Zip | 00961-7035
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Country | US
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Telephone | 305-710-4484
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CALLE SANTA CRUZ, OFICINA 605,
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City | TORRE SAN PABLO
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State | PR
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Zip | 00961-7035
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Country | US
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Telephone | 787-758-1621
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE N MORENO TORRES
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Credential | M.D.
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Telephone | 305-710-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 003254
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License Number State | PR
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