Individual provider · Type 1 NPI

Ezekiel Mauricio

Student in an Organized Health Care Education/Training Program · Portales, NM

NPI number 1013436005 Active

Practice location

1500 S Ave K, Station 3, Shroc
Portales, NM 88130-8813

Call (361) 236-9006 Map

Fax (361) 236-9006

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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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About NPI 1013436005

Ezekiel Mauricio's National Provider Identifier is 1013436005, issued on Sep 12, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portales, NM. The record was last updated on Sep 12, 2017.