Healthcare Provider Details

I. General information

NPI: 1306843511
Provider Name (Legal Business Name): DR. ANTOLIANO TORRES RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1452 CALLE AMERICO SALAS ESQ. PAVIA
SANTURCE PR
00909-2157
US

IV. Provider business mailing address

PLAZA 12 D-4 CAMBRIDGE PARK
RIO PIEDRAS PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-1460
  • Fax: 787-726-5223
Mailing address:
  • Phone: 787-759-8171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4849
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: