Provider Demographics
NPI:1356902514
Name:MORO, JULIO E
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:E
Last Name:MORO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 URB RAHOLISA GDNS
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2415
Mailing Address - Country:US
Mailing Address - Phone:787-943-0045
Mailing Address - Fax:
Practice Address - Street 1:3 URB RAHOLISA GDNS
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2415
Practice Address - Country:US
Practice Address - Phone:787-943-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004879183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist