Provider Demographics
NPI:1588789697
Name:MORALES, LUZ Z
Entity type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:Z
Last Name:MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:# 31 BDA SAN MIGUEL
Mailing Address - Street 2:APARTADO 562
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719
Mailing Address - Country:US
Mailing Address - Phone:787-310-2354
Mailing Address - Fax:787-786-4564
Practice Address - Street 1:# 31 BDA SAN MIGUEL
Practice Address - Street 2:APARTADO 562
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-310-2354
Practice Address - Fax:787-786-4564
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003117183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRLIC003117Medicaid