Healthcare Provider Details

I. General information

NPI: 1629746912
Provider Name (Legal Business Name): ALICIA TORRES-MARTINEZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 09/01/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 AVE. HOSTOS SUITE 7 CENTRO MEDICO
MAYAGUEZ PR
00685
US

IV. Provider business mailing address

HC 8 BOX 82556
SAN SEBASTIAN PR
00685-8659
US

V. Phone/Fax

Practice location:
  • Phone: 787-833-0663
  • Fax:
Mailing address:
  • Phone: 787-223-4548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14843
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: