Provider Demographics
NPI:1841926235
Name:MORALES HERNANDEZ, WILMARIE I (MD)
Entity type:Individual
Prefix:MRS
First Name:WILMARIE
Middle Name:
Last Name:MORALES HERNANDEZ
Suffix:I
Gender:F
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:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-1330
Mailing Address - Country:US
Mailing Address - Phone:787-739-8182
Mailing Address - Fax:787-739-8190
Practice Address - Street 1:BO. JUAN MARTIN
Practice Address - Street 2:CARR 901 KM 1.6
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-0000
Practice Address - Country:US
Practice Address - Phone:787-739-8182
Practice Address - Fax:787-739-8190
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7202103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0082042OtherPTAN