Healthcare Provider Details

I. General information

NPI: 1477989606
Provider Name (Legal Business Name): SILVANO LUIS RODRIGUEZ TORRES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 MAGNOLIA ST
ORANGEBURG SC
29118-1403
US

IV. Provider business mailing address

3709 MAGNOLIA ST
ORANGEBURG SC
29118-1403
US

V. Phone/Fax

Practice location:
  • Phone: 803-531-2220
  • Fax: 803-531-7975
Mailing address:
  • Phone: 803-531-2220
  • Fax: 803-531-7975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number52514
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: