Provider Demographics
NPI:1194793935
Name:MUNTANER-MORALES, ANGEL S (MD)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:S
Last Name:MUNTANER-MORALES
Suffix:
Gender:M
Credentials:MD
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 1001
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-1001
Mailing Address - Country:US
Mailing Address - Phone:787-885-4446
Mailing Address - Fax:787-885-6129
Practice Address - Street 1:205 AVE LAURO PINERO
Practice Address - Street 2:
Practice Address - City:CEIBA
Practice Address - State:PR
Practice Address - Zip Code:00735-2701
Practice Address - Country:US
Practice Address - Phone:787-885-4446
Practice Address - Fax:787-885-6129
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9737208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR201865OtherPREFERRED HEALTHCARE ID
PR060367OtherCRUZ AZUL ID
PR7350001OtherHUMANA ID
PR6804OtherFIRST MEDICAL
PR3943933OtherCIGNA
PR500054SEOtherMMM HEALTHCARE ID
PR23641OtherPROSSAM
PR82186OtherSSS ID
PR1199737OtherGLOBAL HEALTH
PR82186OtherSSS ID
PRF08078Medicare UPIN