Provider Demographics
NPI:1275758021
Name:MORALES OQUENDO, MARIELA (MT)
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:
Last Name:MORALES OQUENDO
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 PASEO GIBRALTAR
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-4786
Mailing Address - Country:US
Mailing Address - Phone:787-872-3428
Mailing Address - Fax:
Practice Address - Street 1:323 PASEO GIBRALTAR
Practice Address - Street 2:POLICLINICA DEL ATLANTICO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4786
Practice Address - Country:US
Practice Address - Phone:787-872-3428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6999246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist