Healthcare Provider Details

I. General information

NPI: 1124089602
Provider Name (Legal Business Name): LUIS MOISES TORRES SERRANT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2006
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 CARR. 2 SUITE 1201 METRO MEDICAL CENTER
BAYAMON PR
00959-1201
US

IV. Provider business mailing address

104 CALLE REINA CATALINA
GUAYNABO PR
00969-3274
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-5060
  • Fax: 787-798-3388
Mailing address:
  • Phone: 787-607-7677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number043
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: