MEDICARE: MELISSA ANNETTE MORALES GARCIA MD

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	208D00000X	General Practice Physician	21514	PR
2	390200000X	Student in an Organized Health Care Education/Training Program	21514	PR
3	2084N0400X	Neurology Physician	21514	PR

General Provider Information

NPI Number	:	1063901304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANNETTE MORALES GARCIA MD

Provider Business Mailing Address
First Line	:	381 AVE FELISA RINCON DE GAUTIER
Second Line	:	CONDOMINIO PASEO MONTE APT 1501
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-399-1551
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 CALLE MANUEL DOMENECH
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3501
Country	:	US
Telephone Number	:	787-399-1551
Fax Number	:

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

Provider Enumeration Date	:	05/02/2018
Last Update Date	:	03/01/2023

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