Provider Demographics
NPI:1265406433
Name:RIVERA MORALES, RAMON C SR (MD)
Entity type:Individual
Prefix:MR
First Name:RAMON
Middle Name:C
Last Name:RIVERA MORALES
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:277 CALLE TRUJILLO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-864-8471
Mailing Address - Fax:787-866-6558
Practice Address - Street 1:CALLE DUGUES #5
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-8471
Practice Address - Fax:787-866-6558
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR10944208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
F70255Medicare UPIN
PR0083639Medicare ID - Type Unspecified