Provider Demographics
NPI:1790316842
Name:FIGUEROA-MORALES, MARIELI
Entity Type:Individual
Prefix:
First Name:MARIELI
Middle Name:
Last Name:FIGUEROA-MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 CARR. 169 BALCONES DE GUAYNABO
Mailing Address - Street 2:APARTMENT 702
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-376-5458
Mailing Address - Fax:
Practice Address - Street 1:AVE PONCE DE LEON 715 PDA 37 1/2
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:787-771-7884
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty