Individual
GRISELLE FORTUNA MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
429 CALLE ALAMEDA, URB SULTANA PARK, MAYAGUEZ, PR 00680-1615
(787) 464-4845
Mailing address
#429 ALAMEDA ST, URB SULTANA PARK, MAYAGUEZ, PR 00680-1615
(787) 464-4845
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
16766
PR
207R00000X
Internal Medicine Physician
Primary
41046
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440473
—
AZ
Enumeration date
12/24/2007
Last updated
10/12/2020
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