Provider Demographics
NPI:1619474111
Name:SIERRA MORALES, CID M (MD)
Entity Type:Individual
Prefix:DR
First Name:CID
Middle Name:M
Last Name:SIERRA 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:CALLE 8, BUZON 47, BARRIO CARMELITA
Mailing Address - Street 2:PARCELA 13A
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3719
Mailing Address - Country:US
Mailing Address - Phone:787-943-0170
Mailing Address - Fax:
Practice Address - Street 1:47 CALLE 8 BARRIO CARMELITA
Practice Address - Street 2:PARCELA 13A
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3719
Practice Address - Country:US
Practice Address - Phone:787-943-0170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19874208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice