Provider Demographics
NPI:1154513026
Name:MORALES, JOSELITO
Entity Type:Individual
Prefix:MR
First Name:JOSELITO
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE UNION #16 BAJOS
Mailing Address - Street 2:JOSELITO MORALES
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667
Mailing Address - Country:US
Mailing Address - Phone:787-538-3186
Mailing Address - Fax:787-831-2095
Practice Address - Street 1:410 AVE HOSTOS SUITE 7
Practice Address - Street 2:CENTRO SALUD MENTAL DE MAYAGUEZ
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1522
Practice Address - Country:US
Practice Address - Phone:787-831-2095
Practice Address - Fax:787-831-2095
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR6503183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician