Healthcare Provider Details

I. General information

NPI: 1619813920
Provider Name (Legal Business Name): JAYCIE LEE CLASS TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 CALLE GEORGETOWN APT 4
SAN JUAN PR
00927-4839
US

IV. Provider business mailing address

1014 CALLE GEORGETOWN APT 4
SAN JUAN PR
00927-4839
US

V. Phone/Fax

Practice location:
  • Phone: 787-948-7168
  • Fax:
Mailing address:
  • Phone: 787-948-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4030
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: