Provider Demographics
NPI:1104110774
Name:MORALES-PEREZ, ALEX GABRIEL
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:GABRIEL
Last Name:MORALES-PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 606480
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-6501
Mailing Address - Country:US
Mailing Address - Phone:787-787-7078
Mailing Address - Fax:787-798-6590
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-363-6162
Practice Address - Fax:508-363-6225
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18647207RC0000X
MA263759207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease