Provider Demographics
NPI: | 1619002664 |
---|---|
Name: | MORALES&GOMEZ INC. |
Entity Type: | Organization |
Organization Name: | MORALES&GOMEZ INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SECRETARY |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | MARIA |
Authorized Official - Middle Name: | E |
Authorized Official - Last Name: | GOMEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 787-286-1012 |
Mailing Address - Street 1: | ESTANCIAS DEL LAGO AVE. |
Mailing Address - Street 2: | 186 |
Mailing Address - City: | CAGUAS |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00726 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-286-1012 |
Mailing Address - Fax: | 787-745-6286 |
Practice Address - Street 1: | ESTANCIAS DEL LAGO AVE. |
Practice Address - Street 2: | 186 |
Practice Address - City: | CAGUAS |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00726 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-286-1012 |
Practice Address - Fax: | 787-745-6286 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-22 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PR | 11326 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Single Specialty |