Healthcare Provider Details

I. General information

NPI: 1417355975
Provider Name (Legal Business Name): MANUEL TORRES TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 12/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CARR. 149 KM 9.8 EXPRESO CIALES A MANATI
CIALES PR
00638
US

IV. Provider business mailing address

500 CARR. 149 SUITE 1
CIALES PR
00638
US

V. Phone/Fax

Practice location:
  • Phone: 787-871-3105
  • Fax: 787-871-3122
Mailing address:
  • Phone: 787-871-3105
  • Fax: 787-871-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number9834
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: