Basic Information
| Provider Information | |||||||||
| NPI: | 1073567855 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | VLADIMIR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | COND MIRAMAR PLZ | ||||||||
| Address2: | PONCE DE LEON 954 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009073646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877244406 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | BARRIO MONACILLO | ||||||||
| Address2: | CARRETERA #22, PASEO DR. JOSE C. BARBOSA | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009350001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773760 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 15053 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.