Healthcare Provider Details

I. General information

NPI: 1750211843
Provider Name (Legal Business Name): MR. ANTONIO LUIS ZAMBRANA TORO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 307, KILOMETRO 3.5
CABO ROJO PR
00623
US

IV. Provider business mailing address

PO BOX 193
CABO ROJO PR
00623-0193
US

V. Phone/Fax

Practice location:
  • Phone: 787-217-2646
  • Fax:
Mailing address:
  • Phone: 787-217-2646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number2302730
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number2302730
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: