Provider Demographics
NPI:1588974430
Name:TIRADO-MORALES, DIMAS JAVIER (MD)
Entity type:Individual
Prefix:
First Name:DIMAS
Middle Name:JAVIER
Last Name:TIRADO-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 1:55 DR. BASORA ST N, EDIF. MEDICO IV
Mailing Address - Street 2:OFFICE 206
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-652-3774
Mailing Address - Fax:
Practice Address - Street 1:55 DR BASORA ST N, EDIF MEDICO IV
Practice Address - Street 2:OFFICE 206
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-652-3774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4472382084P0800X
MDD796342084P0804X
PR218012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry