Provider Demographics
NPI:1700326865
Name:CLEMENTE MORALES, ESTEBAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ESTEBAN
Middle Name:
Last Name:CLEMENTE MORALES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VILLA HUMACAO L-60 CALLE#3
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:939-268-2901
Mailing Address - Fax:
Practice Address - Street 1:CARR 3 KM 19.23 2NDO PISO
Practice Address - Street 2:BO CANOVANAS
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-221-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12121111N00000X
PR510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor