Provider Demographics
NPI:1588222434
Name:OTERO- MORALES, WILCAR ALFREDO (MD)
Entity Type:Individual
Prefix:
First Name:WILCAR
Middle Name:ALFREDO
Last Name:OTERO- MORALES
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:PO BOX 191811
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00919-1811
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL ONCOLOGICO DR. I GONZALEZ MARTINEZ
Practice Address - Street 2:APARTADO 191811
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00919-1811
Practice Address - Country:UM
Practice Address - Phone:787-763-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15051208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice