1760467096 NPI number — DR. JOSE ANIBAL MORALES BARRETO M.D.

Table of content: DR. JOSE ANIBAL MORALES BARRETO M.D. (NPI 1760467096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760467096 NPI number — DR. JOSE ANIBAL MORALES BARRETO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORALES BARRETO
Provider First Name:
JOSE
Provider Middle Name:
ANIBAL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1760467096
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3088
Provider Second Line Business Mailing Address:
MARINA STATION
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-3088
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-833-6069
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14B CALLE COMERCIO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RINCON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-823-1730
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/09/2005

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: 207R00000X , with the licence number:  7569 , 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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