Healthcare Provider Details

I. General information

NPI: 1841336070
Provider Name (Legal Business Name): MRS. LIDIA TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

APARTADO 515
NARANJITO PR
00719
US

IV. Provider business mailing address

URB. MARIA DEL CARMEN CALLE 12 P-4
COROZAL PR
00783
US

V. Phone/Fax

Practice location:
  • Phone: 787-869-5900
  • Fax:
Mailing address:
  • Phone: 787-859-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2175
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: