Provider Demographics
NPI:1811462740
Name:MORALES, NANCY E
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:MORALES
Suffix:
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 1:5349 ISLA VERDE AVE.
Mailing Address - Street 2:MARBELLA EAST, APT. 1403
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-460-4811
Mailing Address - Fax:
Practice Address - Street 1:5984 AVE ISLA VERDE
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5776
Practice Address - Country:US
Practice Address - Phone:787-982-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist