Provider Demographics
NPI:1134249543
Name:MORALES-RIVERA, CRUCIE (DC)
Entity type:Individual
Prefix:DR
First Name:CRUCIE
Middle Name:
Last Name:MORALES-RIVERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37915
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00937-0915
Mailing Address - Country:US
Mailing Address - Phone:787-777-8145
Mailing Address - Fax:787-777-8147
Practice Address - Street 1:VILLAS DE SAN FRANCISCO, PLAZA I
Practice Address - Street 2:AVE, DE DIEGO 89
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-774-8145
Practice Address - Fax:787-777-8147
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0370111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NT0100XChiropractic ProvidersChiropractorThermography
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR006-8173Medicare PIN