Healthcare Provider Details

I. General information

NPI: 1669430096
Provider Name (Legal Business Name): CARLOS MANUEL TORRES-TORRES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 AVE AMERICO MIRANDA REPARTO METROPOLITANO
SAN JUAN PR
00921-2119
US

IV. Provider business mailing address

1372 CALLE 12 NW PUERTO NUEVO
SAN JUAN PR
00920-2231
US

V. Phone/Fax

Practice location:
  • Phone: 787-782-1124
  • Fax: 787-782-1124
Mailing address:
  • Phone: 787-783-4737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9312
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: