Provider Demographics
NPI:1841411121
Name:MORALES, MARIE YELITZA
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:YELITZA
Last Name: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:URBANIZACION MONTEREY CALLE 2 D18
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783
Mailing Address - Country:US
Mailing Address - Phone:787-859-1961
Mailing Address - Fax:
Practice Address - Street 1:D18 CALLE 2
Practice Address - Street 2:URB. MONTEREY
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2306
Practice Address - Country:US
Practice Address - Phone:787-859-1961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1041390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program