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Ezekiel Mauricio
Student in an Organized Health Care Education/Training Program in Portales, New Mexico
NPI 1013436005

Ezekiel Mauricio is a Student in an Organized Health Care Education/Training Program based in Portales, NM. Ezekiel Mauricio practices in Portales, NM. The NPI Number for Ezekiel Mauricio is 1013436005 and holds a License No. (New Mexico).

The current practice location address for Ezekiel Mauricio is 1500 S Ave K, Portales, NM and can be reached out via phone at 361-236-9006 and via fax at 361-236-9006.

Location: 1500 S Ave K, Portales, NM, 88130
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013436005
Provider Name
Ezekiel Mauricio
Credential
Provider Entity Type
Individual
Gender
Male
Address
1500 S Ave K, Portales, NM, 88130
Phone Number
361-236-9006
Fax Number
361-236-9006
Provider Enumeration Date
09/12/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1500 S Ave K
City
Portales
State
New Mexico
Zip
88130-8813
Phone Number
361-236-9006
Fax Number
361-236-9006
person
Provider Business Mailing Address Details
Address
1500 S Ave K
City
Portales
State
New Mexico
Zip
88130-8813
Phone Number
361-236-9006
Fax Number
361-236-9006
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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