Provider Demographics
NPI:1932328812
Name:QUIMIO AMB DR RAUL MORALES BORGES
Entity Type:Organization
Organization Name:QUIMIO AMB DR RAUL MORALES BORGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-722-0412
Mailing Address - Street 1:29 CALLE WASHINGTON
Mailing Address - Street 2:SUITE # 104
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1510
Mailing Address - Country:US
Mailing Address - Phone:787-722-0412
Mailing Address - Fax:787-723-0554
Practice Address - Street 1:29 CALLE WASHINGTON
Practice Address - Street 2:SUITE # 104
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-722-0412
Practice Address - Fax:787-723-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10718261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR12940OtherTRIPLE S PROVIDER NUMBER