Ezekiel Mauricio

NPI #1013436005 in Portales, New Mexico

Provider Information

NPI Number: 1013436005
Entity Type: Individual
Name: Ezekiel Mauricio
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 12, 2017
Last Updated: Sep 12, 2017

Practice Location

Address: 1500 S AVE K
Address 2: STATION 3, SHROC
City: Portales
State: New Mexico
ZIP Code: 88130-8813
Phone: (361) 236-9006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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