Healthcare Provider Details

I. General information

NPI: 1043294309
Provider Name (Legal Business Name): JOSE NIN-TORREGROSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 AVE PONCE DE LEON SUITE 618
SAN JUAN PR
00918-1621
US

IV. Provider business mailing address

PO BOX 1679
CANOVANAS PR
00729-1679
US

V. Phone/Fax

Practice location:
  • Phone: 787-550-0791
  • Fax: 888-454-6294
Mailing address:
  • Phone: 787-550-0790
  • Fax: 888-454-6294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3760
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number3760
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: