Organization

Alvaro J Moreno Od Pc

Clinic/Center in Petal, MS(View on Map)

Legal Business Name

Alvaro J Moreno Od Pc

NPI Number

1013085935

NPI Type

Organization

Enumeration Date

11/30/2006

Specialties

(Taxonomies)

Code

261Q00000X
152W00000X

Primary Taxonomy

Yes
No

Licenses

State

Mississippi

License Number

610

Contact
Information

Purpose

Mailing
Location

Address

598 E CENTRAL AVE
598 E CENTRAL AVE

City

Petal
Petal

State

MS
MS

Postal Code

39465-2957
39465-2957

Country

US
US

Telephone Number

(601) 450-3937
(601) 450-3937

Authorized Official

Name

Dr. Alvaro Moreno

Title or Position

OWNER

Telephone Number

(601) 549-1553

Identifiers

Identifier

08637209

Identifier State

MS

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/08/2020

Provider Address