Provider Demographics
NPI:1295852580
Name:ZEDA-MORALES, EVELYN A (MD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:A
Last Name:ZEDA-MORALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 AVE CONSTITUCION
Mailing Address - Street 2:SAN JUAN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-2321
Mailing Address - Country:US
Mailing Address - Phone:787-380-1072
Mailing Address - Fax:
Practice Address - Street 1:550 AVE CONSTITUCION
Practice Address - Street 2:SAN JUAN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-2321
Practice Address - Country:US
Practice Address - Phone:787-380-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15404207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15404OtherMEDICAL LICENSE