Provider Demographics
NPI:1255435426
Name:MORALES-RALAT, ASTRID (MD)
Entity type:Individual
Prefix:DR
First Name:ASTRID
Middle Name:
Last Name:MORALES-RALAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 TERRALINDA ESTATES
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-876-2042
Mailing Address - Fax:787-876-7416
Practice Address - Street 1:BOX 509 188 ST. INT. 187
Practice Address - Street 2:
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-876-7415
Practice Address - Fax:787-876-7416
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine