Provider Demographics
NPI:1649583121
Name:MORALES, RAFAEL L (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:L
Last Name:MORALES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2399 ROUTE #2
Mailing Address - Street 2:WEST BAYAMON
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-474-6929
Mailing Address - Fax:787-474-6948
Practice Address - Street 1:2399 ROUTE #2
Practice Address - Street 2:WEST BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-474-6929
Practice Address - Fax:787-474-6948
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist