Healthcare Provider Details

I. General information

NPI: 1518616259
Provider Name (Legal Business Name): PAULO ANIBAL TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 AVE JOSE DE DIEGO URB. SAN FRANCISCO
SAN JUAN PR
00927
US

IV. Provider business mailing address

PO BOX 270066
SAN JUAN PR
00928-2866
US

V. Phone/Fax

Practice location:
  • Phone: 787-400-5292
  • Fax:
Mailing address:
  • Phone: 787-400-5292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number843
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number843
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: