Provider Demographics
NPI:1790754042
Name:MORALES ALVARADO, JOSE L SR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:L
Last Name:MORALES ALVARADO
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:SANTA CRUZ #73 SUITE 203
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6911
Mailing Address - Country:US
Mailing Address - Phone:787-780-4095
Mailing Address - Fax:787-269-3147
Practice Address - Street 1:EDIF MEDICO SANTA CRUZ
Practice Address - Street 2:SUITE 203
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-780-4095
Practice Address - Fax:787-269-3147
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR4245207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR25096Medicare ID - Type Unspecified
PRC79423Medicare UPIN