Provider Demographics
NPI:1760467096
Name:MORALES BARRETO, JOSE ANIBAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANIBAL
Last Name:MORALES BARRETO
Suffix:
Gender:M
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:PO BOX 3088
Mailing Address - Street 2:MARINA STATION
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3088
Mailing Address - Country:US
Mailing Address - Phone:787-833-6069
Mailing Address - Fax:
Practice Address - Street 1:14B CALLE COMERCIO
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677
Practice Address - Country:US
Practice Address - Phone:787-823-1730
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89277Medicare ID - Type Unspecified
PRF64257Medicare UPIN