MEDICARE: DR. AIDA LUZ TORRES M.D.

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	208D00000X	General Practice Physician	4740	PR

General Provider Information

NPI Number	:	1609083427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AIDA LUZ TORRES M.D.

Provider Business Mailing Address
First Line	:	100 AVE LOS SAUCES
Second Line	:	MANSIONES DE SIERRA TAINA HC-67 BOX 100
City	:	BAYAMON
State	:	PR
Zip	:	00956-9545
Country	:	US
Telephone Number	:	787-786-7678
Fax Number	:	787-786-7678

Provider Business Practice Location Address
First Line	:	100 AVE LOS SAUCES
Second Line	:	MANSIONES DE SIERRA TAINA HC-67 BOX 100
City	:	BAYAMON
State	:	PR
Zip	:	00956-9545
Country	:	US
Telephone Number	:	787-786-7678
Fax Number	:	787-786-7678

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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