Individual
MRS. ESMERALDA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
HC 83 BOX 6184, VEGA ALTA, PR 00692-9723
(704) 852-2403
Mailing address
HC 83 BOX 6184, VEGA ALTA, PR 00692-9723
(704) 852-2403
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1988
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1988
PUERTO RICO GOVERMENT, DEPARTMENT OF HEALTH
PR
01
—
E69635585
PCA CERTIFICATE
VA
Enumeration date
05/08/2015
Last updated
01/15/2024
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