Provider Demographics
NPI:1588748826
Name:FARINACCI MORALES, PEDRO N (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:N
Last Name:FARINACCI 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:PMB 128 BOX 2000
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715
Mailing Address - Country:US
Mailing Address - Phone:787-825-2121
Mailing Address - Fax:787-825-5625
Practice Address - Street 1:PMB 128 BOX 2000
Practice Address - Street 2:
Practice Address - City:MERCEDITA
Practice Address - State:PR
Practice Address - Zip Code:00715
Practice Address - Country:US
Practice Address - Phone:787-825-2121
Practice Address - Fax:787-825-5625
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR135322085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020878Medicare ID - Type Unspecified