Healthcare Provider Details

I. General information

NPI: 1245151208
Provider Name (Legal Business Name): MISS IDALMARIS TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 AVE TITO CASTRO
PONCE PR
00716-0201
US

IV. Provider business mailing address

PO BOX 1126
PENUELAS PR
00624-1126
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-2135
  • Fax: 787-284-2135
Mailing address:
  • Phone: 939-314-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number17573
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: