MEDICARE: LOURDES MORALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1023795275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOURDES MORALES

Provider Business Mailing Address
First Line	:	931 S DAHLIA ST APT 103
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-2677
Country	:	US
Telephone Number	:	720-292-7928
Fax Number	:

Provider Business Practice Location Address
First Line	:	931 S DAHLIA ST APT 103
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-2677
Country	:	US
Telephone Number	:	720-292-7928
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	06/29/2023

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Directions to “ LOURDES MORALES ” Practice Location

Language	Start Address	Practice Location

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