Healthcare Provider Details

I. General information

NPI: 1093254021
Provider Name (Legal Business Name): TORRES OPTICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

H13 CALLE 1 RIVERSIDE PARK
BAYAMON PR
00961-8585
US

IV. Provider business mailing address

H13 CALLE 1 RIVERSIDE PARK
BAYAMON PR
00961-8585
US

V. Phone/Fax

Practice location:
  • Phone: 787-379-6680
  • Fax:
Mailing address:
  • Phone: 787-379-6680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MARIMAR TORRES
Title or Position: PRESIDENT
Credential:
Phone: 787-379-6680