Healthcare Provider Details

I. General information

NPI: 1629261110
Provider Name (Legal Business Name): ELBA TORRES-MATUNDAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELBA TORRES ALVAREZ MD

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 CALLE TRINIDAD STE 102
SAN JUAN PR
00917-2900
US

IV. Provider business mailing address

198 CALLE TRINIDAD
SAN JUAN PR
00917-2900
US

V. Phone/Fax

Practice location:
  • Phone: 787-726-5486
  • Fax: 787-268-4417
Mailing address:
  • Phone: 787-605-5048
  • Fax: 787-269-6442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number14991
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: