MEDICARE: UNIVERSIDAD DE PUERTO RICO RECINTO DE CIENCIAS MEDICAS

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	122300000X	Dentist	2561	PR

General Provider Information

NPI Number	:	1487860706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSIDAD DE PUERTO RICO RECINTO DE CIENCIAS MEDICAS

Provider Business Mailing Address
First Line	:	PO BOX 6021
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00984-6021
Country	:	US
Telephone Number	:	787-757-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR. 3 KM 8.3
Second Line	:	AVE. 65 DE INFANTERIA
City	:	CAROLINA
State	:	PR
Zip	:	00984-6021
Country	:	US
Telephone Number	:	787-757-1800
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ERIC X TORRES
Credential	:	D.M.D., M.P.H.
Telephone Number	:	787-757-1800

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2010

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