Provider Demographics
NPI:1801197223
Name:CARBONELL MORALES, MARICELI
Entity Type:Individual
Prefix:
First Name:MARICELI
Middle Name:
Last Name:CARBONELL 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:HC 37 BOX 5206
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-8462
Mailing Address - Country:US
Mailing Address - Phone:787-832-3020
Mailing Address - Fax:
Practice Address - Street 1:HC 37 BOX 5206
Practice Address - Street 2:
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653-8462
Practice Address - Country:US
Practice Address - Phone:787-832-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28042163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse