Provider Demographics
NPI:1811880131
Name:MOANES MEDIAL SERVICES LLC
Entity type:Organization
Organization Name:MOANES MEDIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:787-607-7677
Mailing Address - Street 1:104 CALLE REINA CATALINA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3274
Mailing Address - Country:US
Mailing Address - Phone:787-607-7677
Mailing Address - Fax:
Practice Address - Street 1:1845 CARR 2 BAYAMON MEDICAL PLAZA
Practice Address - Street 2:SUITE 805
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-740-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty