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General NPI Number Information
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NPI Number | 1891259784
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Entity Type | Individual
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Provider Name | ELIEZER TORRES SANTIAGO
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Gender | Male
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Dates
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Enumeration Date | 01/25/2019
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 188 CALLE NORTE
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City | DORADO
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State | PR
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Zip | 00646-2743
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Country | US
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Telephone | 787-278-8888
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Fax | 787-278-8888
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Provider Business Mailing Address
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Address Line | HH5 CALLE PELICANO URB. DORADO DEL MAR
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-342-1302
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Fax | 787-278-8888
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301
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License Number State | PR
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