Healthcare Provider Details

I. General information

NPI: 1063999357
Provider Name (Legal Business Name): JULIANA IVETTE TORRENS VAZQUEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 CALLE FONT MARTELO
HUMACAO PR
00791-3225
US

IV. Provider business mailing address

PO BOX 867
LAS PIEDRAS PR
00771-0867
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-0768
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24231
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number71811
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number24231
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: