Individual
DR. NICOLE MAYRIM BAEZ MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
AVE.PONCE DE LEON 255, HATO REY, SAN JUAN, PR 00916
(787) 758-2500
Mailing address
PO BOX 723, FAJARDO, PR 00738-0723
(787) 435-3977
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
021755
PR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/01/2019
Last updated
07/17/2020
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