Healthcare Provider Details

I. General information

NPI: 1386722551
Provider Name (Legal Business Name): LUIS ANGEL TORRES SUAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST 36 ZAI URB RIVERVIEW
BAYAMON PR
00961
US

IV. Provider business mailing address

PO BOX 2105
BAYAMON PR
00960-2105
US

V. Phone/Fax

Practice location:
  • Phone: 787-785-2694
  • Fax: 787-787-3109
Mailing address:
  • Phone: 787-785-2694
  • Fax: 787-787-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5098
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: