1386961670 NPI number — MISS CORALIMAR ZAYAS MORALES MS PHL

Table of content: MISS CORALIMAR ZAYAS MORALES MS PHL (NPI 1386961670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386961670 NPI number — MISS CORALIMAR ZAYAS MORALES MS PHL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAYAS MORALES
Provider First Name:
CORALIMAR
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MS PHL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386961670
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 758
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CIDRA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00739-0758
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-371-6137
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CAR. 171
Provider Second Line Business Practice Location Address:
BO. SUD
Provider Business Practice Location Address City Name:
CIDRA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00739-0758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-484-8702
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  4053 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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