MEDICARE: MR. WODEN E. TORRES D.O.

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	156FX1800X	Optician	739	PR

General Provider Information

NPI Number	:	1720265630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WODEN E. TORRES D.O.

Provider Business Mailing Address
First Line	:	JUNCOS PLAZA SHOPPING CENTER
Second Line	:	SUITE D-8
City	:	JUNCOS
State	:	PR
Zip	:	00777-0000
Country	:	US
Telephone Number	:	787-713-0967
Fax Number	:

Provider Business Practice Location Address
First Line	:	JUNCOS PLAZA SHOPPING CENTER
Second Line	:	SUITE D-8
City	:	JUNCOS
State	:	PR
Zip	:	00777-0000
Country	:	US
Telephone Number	:	787-713-0967
Fax Number	:

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

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	01/23/2008

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