MEDICARE: MARIAN 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	183700000X	Pharmacy Technician		PR

General Provider Information

NPI Number	:	1174777833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAN MORALES

Provider Business Mailing Address
First Line	:	PO BOX 191227
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-1227
Country	:	US
Telephone Number	:	787-758-2000
Fax Number	:	787-771-7884

Provider Business Practice Location Address
First Line	:	AVE PONCE DE LEON # 715
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00907-3380
Country	:	US
Telephone Number	:	787-758-2000
Fax Number	:	787-771-7884

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

Provider Enumeration Date	:	11/07/2008
Last Update Date	:	11/07/2008

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Directions to “ MARIAN MORALES ” Practice Location

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