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General NPI Number Information
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NPI Number | 1386865376
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Entity Type | Individual
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Provider Name | DR. EDWIN MORENO TORRES
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FLORENCE SANTIAGO NO 47 SUITE 2
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-842-9828
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3000 SUITE 257
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-436-3906
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Fax | 787-842-9828
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 5645
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License Number State | PR
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