Provider Demographics
NPI:1972900348
Name:VALENTIN MORALES, MILAGROS SR
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:
Last Name:VALENTIN MORALES
Suffix:SR
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:CC24 CALLE 28
Mailing Address - Street 2:URBANIZACION VISTA AZUL
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-391-6409
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION VISTA AZUL CALLE 28 CC24
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:UM
Practice Address - Phone:787-391-6409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR007238183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician