MEDICARE: DR. EDWIN CANDELARIO-TORRES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	7101	PR
2	207V00000X	Obstetrics & Gynecology Physician	7101	PR

General Provider Information

NPI Number	:	1164406815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWIN CANDELARIO-TORRES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 140279
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00614-0279
Country	:	US
Telephone Number	:	787-880-2076
Fax Number	:	787-817-8894

Provider Business Practice Location Address
First Line	:	MEDICAL & PROFESSIONAL OFFICE PLAZA
Second Line	:	SUITE 132
City	:	HATILLO
State	:	PR
Zip	:	00659-0000
Country	:	US
Telephone Number	:	787-880-2076
Fax Number	:	787-817-8894

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	11/03/2016

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