MEDICARE: DR. NEISA M TORRES REYES MD

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	174400000X	Specialist	12767	PR

General Provider Information

NPI Number	:	1629016829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEISA M TORRES REYES MD

Provider Business Mailing Address
First Line	:	PO BOX 6897
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-5897
Country	:	US
Telephone Number	:	787-485-9739
Fax Number	:	787-779-5297

Provider Business Practice Location Address
First Line	:	64 CALLE SANTA CRUZ
Second Line	:	EDIF GALERIA MEDICA SUITE 201
City	:	BAYAMON
State	:	PR
Zip	:	00961-7003
Country	:	US
Telephone Number	:	787-778-7232
Fax Number	:

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	04/23/2015

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