Healthcare Provider Details
I. General information
NPI: 1376739748
Provider Name (Legal Business Name): LIS TORRES HS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/19/2007
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 2ND ST SW SUITE 5314
WASHINGTON DC
20593-0002
US
IV. Provider business mailing address
5 CALLE LA PUNTILLA
SAN JUAN PR
00901-1818
US
V. Phone/Fax
- Phone: 202-267-0801
- Fax: 202-267-4685
- Phone: 787-729-2305
- Fax: 787-289-7991
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 247200000X |
| Taxonomy | Other Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: