Healthcare Provider Details

I. General information

NPI: 1487765087
Provider Name (Legal Business Name): LUIS C TORRELLAS RUIZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 CALLE FONT MARTELO
HUMACAO PR
00791-3345
US

IV. Provider business mailing address

PO BOX 9290
HUMACAO PR
00792-9290
US

V. Phone/Fax

Practice location:
  • Phone: 787-474-0406
  • Fax: 787-474-0406
Mailing address:
  • Phone: 787-474-0406
  • Fax: 787-474-0406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number13413
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number13413
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: