MEDICARE: NADYA MILAGROS MORALES LEBRON 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	207P00000X	Emergency Medicine Physician	16287	PR

General Provider Information

NPI Number	:	1972758134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADYA MILAGROS MORALES LEBRON MD

Provider Business Mailing Address
First Line	:	1527 AVE. PONCE DE LEON SECTOR 5 STE. 105
Second Line	:
City	:	SAN JUAN
State	:	PUERTO RICO
Zip	:	00926
Country	:	UM
Telephone Number	:	787-674-1272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1527 AVE PONCE DE LEON # 5
Second Line	:	SUITE 105
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2724
Country	:	US
Telephone Number	:	787-674-1272
Fax Number	:

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

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	07/30/2024

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