Provider Demographics
NPI:1447458765
Name:MORALES BURGOS, ADISBETH (MD)
Entity type:Individual
Prefix:DR
First Name:ADISBETH
Middle Name:
Last Name:MORALES BURGOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE LOPATEGUI # 50
Mailing Address - Street 2:PARKVILLE PLAZA APT 105
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4595
Mailing Address - Country:US
Mailing Address - Phone:787-914-7935
Mailing Address - Fax:
Practice Address - Street 1:735 AVE PONCE DE LEON
Practice Address - Street 2:TORRE MEDICA AUXILIO MUTUO SUITE 802
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917-5022
Practice Address - Country:US
Practice Address - Phone:787-296-0944
Practice Address - Fax:787-545-1762
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16921174400000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No174400000XOther Service ProvidersSpecialist