Individual
DR. JOSE LUIS MORALES VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
Mailing address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
15082
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15082
STATE LICENSE
PR
Enumeration date
01/25/2006
Last updated
03/07/2023
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