Healthcare Provider Details

I. General information

NPI: 1093030272
Provider Name (Legal Business Name): BENITO TORRES SILVA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 03/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE WILSON 2011
PONCE PUERTO RICO
00730
UM

IV. Provider business mailing address

P.O BOX 8723
PONCE PUERTO RICO
00732
UM

V. Phone/Fax

Practice location:
  • Phone: 787-989-2076
  • Fax: 787-841-6517
Mailing address:
  • Phone: 787-989-2076
  • Fax: 787-841-6517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number9908
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: