Provider Demographics
NPI:1699794982
Name:MORALES -VALES, MIGUEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:J
Last Name:MORALES -VALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1323
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1323
Mailing Address - Country:US
Mailing Address - Phone:787-860-5140
Mailing Address - Fax:787-860-5140
Practice Address - Street 1:98 CALLE GARRIDO MORALES E
Practice Address - Street 2:OFICINA 102
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4690
Practice Address - Country:US
Practice Address - Phone:787-860-5140
Practice Address - Fax:787-860-5140
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9455208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE44010Medicare UPIN
PR81348Medicare ID - Type Unspecified