Healthcare Provider Details

I. General information

NPI: 1639090418
Provider Name (Legal Business Name): LEONEL TORRES BENITEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

CALLE VICTORIA 1551 SANTURCE
SAN JUAN PR
00912-3123
US

IV. Provider business mailing address

CALLE 15 1278 URB MONTE CARLO
SAN JUAN PR
00924
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-9595
  • Fax:
Mailing address:
  • Phone: 787-643-3206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number0003351
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: