Provider Demographics
NPI:1629518642
Name:MORALES GONZALEZ PRIMARY CARE SERVICES INC.
Entity Type:Organization
Organization Name:MORALES GONZALEZ PRIMARY CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:AMILCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES PRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-408-3471
Mailing Address - Street 1:HC 1 BOX 6331
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-9712
Mailing Address - Country:US
Mailing Address - Phone:787-415-9877
Mailing Address - Fax:787-821-0117
Practice Address - Street 1:CARR 116 KM 24.7
Practice Address - Street 2:PLAZA GUANICA
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653
Practice Address - Country:US
Practice Address - Phone:787-821-0117
Practice Address - Fax:787-821-0117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1700901097OtherNPI