Provider Demographics
NPI:1215130588
Name:MORALES-VASQUEZ, LILLIANA (MD)
Entity type:Individual
Prefix:DR
First Name:LILLIANA
Middle Name:
Last Name:MORALES-VASQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LILLIANA
Other - Middle Name:
Other - Last Name:MORALES-VAZQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 16598
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-6598
Mailing Address - Country:US
Mailing Address - Phone:787-525-6075
Mailing Address - Fax:
Practice Address - Street 1:1449 CALLE AMERICO SALAS STE 103
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2104
Practice Address - Country:US
Practice Address - Phone:787-722-1717
Practice Address - Fax:787-723-1595
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17493207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine