Provider Demographics
NPI:1437741873
Name:MORA, OSWALD ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:OSWALD
Middle Name:ROBERTO
Last Name:MORA
Suffix:
Gender:M
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:HC 6 BOX 10170
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-6624
Mailing Address - Country:US
Mailing Address - Phone:787-404-4304
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 141.1 AVENIDA SEVERIANO CUEVAS
Practice Address - Street 2:18 CAIMITAL BAJO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-658-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15708I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program