Provider Demographics
NPI:1477436764
Name:MORA ENDOCRINOLOGY AND DIABETES CLINIC LLC
Entity type:Organization
Organization Name:MORA ENDOCRINOLOGY AND DIABETES CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORA OSORIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-567-9122
Mailing Address - Street 1:CONDOMINIO PARQUE CENTRO ALEU
Mailing Address - Street 2:C28 170 AVE ARTERIAL AV H
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-567-9122
Mailing Address - Fax:
Practice Address - Street 1:DEL NORTE PROFESSIONAL CENTER OFICINA 303
Practice Address - Street 2:CARR 493 BO CARRIZALES KM 0.9
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-224-4902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty