Healthcare Provider Details

I. General information

NPI: 1225963564
Provider Name (Legal Business Name): LUIS D TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RESIDENCIAL LOS FLAMBOYANES EDIFICIO G. APARTAMENTO #42
PENUELAS PR
00624
US

IV. Provider business mailing address

RESIDENCIAL LOS FLAMBOYANES EDIFICIO G. APARTAMENTO #42
PENUELAS PR
00624
US

V. Phone/Fax

Practice location:
  • Phone: 939-328-7638
  • Fax:
Mailing address:
  • Phone: 939-328-7638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number5020178
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: