MEDICARE: DR. LUIS J TORRUELLA MD, FACS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	10536	PR

General Provider Information

NPI Number	:	1205899853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS J TORRUELLA MD, FACS

Provider Business Mailing Address
First Line	:	909 AVE TITO CASTRO SUITE 822
Second Line	:	TORRE MEDICA SAN LUCAS
City	:	PONCE
State	:	PR
Zip	:	00716-4725
Country	:	US
Telephone Number	:	787-284-0804
Fax Number	:	787-284-0512

Provider Business Practice Location Address
First Line	:	909 AVE TITO CASTRO SUITE 822
Second Line	:	TORRE MEDICA SAN LUCAS
City	:	PONCE
State	:	PR
Zip	:	00716-4725
Country	:	US
Telephone Number	:	787-284-0804
Fax Number	:	787-284-0512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	10/22/2007

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