Provider Demographics
NPI:1740382076
Name:MORALES, MINERVA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MINERVA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 CALLE AGUAS CALIENTES
Mailing Address - Street 2:VENUS GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4617
Mailing Address - Country:US
Mailing Address - Phone:787-755-3366
Mailing Address - Fax:
Practice Address - Street 1:680 CALLE AGUAS CALIENTES
Practice Address - Street 2:VENUS GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4617
Practice Address - Country:US
Practice Address - Phone:787-755-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist