Provider Demographics
NPI:1477924850
Name:JOSE M MORALES CASTRO MD PSC
Entity Type:Organization
Organization Name:JOSE M MORALES CASTRO MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-370-0929
Mailing Address - Street 1:35 CALLE JUAN C BORBON STE 67
Mailing Address - Street 2:PMB 182
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5375
Mailing Address - Country:US
Mailing Address - Phone:787-370-1330
Mailing Address - Fax:
Practice Address - Street 1:1510 AVE FD ROOSEVELT
Practice Address - Street 2:SUITE B
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-2602
Practice Address - Country:US
Practice Address - Phone:787-370-1330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10614261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty