Provider Demographics
NPI:1235627944
Name:MORALES, ROXANNE M (ND)
Entity Type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:M
Last Name:MORALES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3L20 CALLE NALON
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-5334
Mailing Address - Country:US
Mailing Address - Phone:787-368-1690
Mailing Address - Fax:
Practice Address - Street 1:3L20 CALLE NALON
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-5334
Practice Address - Country:US
Practice Address - Phone:787-368-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR53175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty