MEDICARE: MR. KELMIE TORRES RIVERA RN

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	163W00000X	Registered Nurse	71611	PR

General Provider Information

NPI Number	:	1407702269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KELMIE TORRES RIVERA RN

Provider Business Mailing Address
First Line	:	CALLE CLARISAS
Second Line	:	1202
City	:	PONCE
State	:	PR
Zip	:	00730
Country	:	US
Telephone Number	:	787-344-4215
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE CLARISAS
Second Line	:	1202
City	:	PONCE
State	:	PR
Zip	:	00730
Country	:	US
Telephone Number	:	787-344-4215
Fax Number	:

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

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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