Healthcare Provider Details

I. General information

NPI: 1023066511
Provider Name (Legal Business Name): LUIS TORRES VERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 AVE HOSTOS SUITE 101
SAN JUAN PR
00918-3237
US

IV. Provider business mailing address

508 AVE HOSTOS SUITE 101
SAN JUAN PR
00918-3237
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-3024
  • Fax: 787-274-1407
Mailing address:
  • Phone: 787-764-3024
  • Fax: 787-274-1407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number3690
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: