Healthcare Provider Details

I. General information

NPI: 1629907993
Provider Name (Legal Business Name): KORAYMA M TORRES RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE CONCORDIA EDF SAN VICENTE 8169 SUITE 412
PONCE PR
00717
US

IV. Provider business mailing address

P16 CALLE 11
YAUCO PR
00698-3440
US

V. Phone/Fax

Practice location:
  • Phone: 787-284-5884
  • Fax:
Mailing address:
  • Phone: 787-284-5884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: