Provider Demographics
NPI:1063244887
Name:MORALES, JEANELYS NICOLE (BSMHSAMBA)
Entity type:Individual
Prefix:MS
First Name:JEANELYS
Middle Name:NICOLE
Last Name:MORALES
Suffix:
Gender:F
Credentials:BSMHSAMBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 105 KM 20.0 BO. MONTOSO SECTOR LA CARMEN
Mailing Address - Street 2:HC01 BOX 8286
Mailing Address - City:MARICAO
Mailing Address - State:PR
Mailing Address - Zip Code:00606
Mailing Address - Country:US
Mailing Address - Phone:787-451-7617
Mailing Address - Fax:
Practice Address - Street 1:CARR 105 KM 20.0 BO. MONTOSO SECTOR LA CARMEN
Practice Address - Street 2:HC01 BOX 8286
Practice Address - City:MARICAO
Practice Address - State:PR
Practice Address - Zip Code:00606
Practice Address - Country:US
Practice Address - Phone:787-451-7617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic