Provider Demographics
NPI:1750850855
Name:ALOMAR, MOISES SR (RN)
Entity Type:Individual
Prefix:
First Name:MOISES
Middle Name:
Last Name:ALOMAR
Suffix:SR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 LA GRANJA
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-9150
Mailing Address - Country:US
Mailing Address - Phone:939-339-3707
Mailing Address - Fax:
Practice Address - Street 1:SABANA SECA
Practice Address - Street 2:PR-867 KM 2.2
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00952
Practice Address - Country:US
Practice Address - Phone:787-641-0773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87463163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR87463OtherRN LICENSE
PR6171615OtherDRIVER LICENSE
PR6171615OtherDRIVER LICENSE