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General NPI Number Information
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NPI Number | 1881671196
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Entity Type | Individual
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Provider Name | ERVING DIAZ-TORRES M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | AVE MAGNOLIA O-2 MAGNOLIA GARDENS
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City | BAYAMON
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-995-4789
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 56011
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City | BAYAMON
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State | PR
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Zip | 00960-6211
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Country | US
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Telephone | 787-730-3327
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 15714
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License Number State | PR
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