Individual
JOHN BRYAN KELLY MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
EDIFICIO A, 917 AV. TITO CASTRO PISO 4, PONCE, PR 00732
(787) 844-2080
Mailing address
MIRADERO GARDENS CALLE COQUI 719, MAYAGUEZ, PR 00682
(787) 552-0318
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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