MEDICARE: YASHIRA M TORRES SPL

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	235Z00000X	Speech-Language Pathologist	004048	PR

General Provider Information

NPI Number	:	1235678210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASHIRA M TORRES SPL

Provider Business Mailing Address
First Line	:	409 COND CRYSTAL HOUSE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00923
Country	:	US
Telephone Number	:	787-428-1619
Fax Number	:

Provider Business Practice Location Address
First Line	:	368 CALLE DE DIEGO
Second Line	:	COND CRYSTAL HOUSE APT 409
City	:	SAN JUAN
State	:	PR
Zip	:	00923-2916
Country	:	US
Telephone Number	:	787-428-1618
Fax Number	:

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

Provider Enumeration Date	:	02/23/2017
Last Update Date	:	02/23/2017

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Directions to “ YASHIRA M TORRES SPL” Practice Location

Language	Start Address	Practice Location

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