Healthcare Provider Details

I. General information

NPI: 1104193853
Provider Name (Legal Business Name): TORRES & DEL VALLE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET #2 KM 56.8
BARCELONETA PR
00617
US

IV. Provider business mailing address

735 AVE PONCE DE LEON STE 715
SAN JUAN PR
00917-5030
US

V. Phone/Fax

Practice location:
  • Phone: 787-250-0125
  • Fax: 787-773-8008
Mailing address:
  • Phone: 787-205-0125
  • Fax: 787-773-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. AMILCAR TORRES
Title or Position: DIRECTOR
Credential: MD
Phone: 787-250-0125