Healthcare Provider Details

I. General information

NPI: 1912900093
Provider Name (Legal Business Name): ISMAEL TORRES ROSARIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date: 04/04/2025
Reactivation Date: 04/16/2025

III. Provider practice location address

2 CALLE ROSANTA AULET
JAYUYA PR
00664-1328
US

IV. Provider business mailing address

URB VALLE ESCONDIDO #47
GUAYNABO PR
00971-8002
US

V. Phone/Fax

Practice location:
  • Phone: 787-373-0984
  • Fax:
Mailing address:
  • Phone: 787-373-0984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number8311
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: