Basic Information
| Provider Information | |||||||||
| NPI: | 1851870083 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORALES FIGUEROA | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | BSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4091 PUNTO ORO CALLE COCOLLO | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9398814497 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CONSOLIDATED MALL B5 | ||||||||
| Address2: | 202 AVE GAUTIER BENITEZ | ||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877040705 | ||||||||
| FaxNumber: | 7877447444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2018 | ||||||||
| LastUpdateDate: | 08/08/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 77454 | PR | Y | Nursing Service Providers | Registered Nurse | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 077454 | 01 | PR | NURSING | OTHER |