MEDICARE: MARLA LOREN TORRES - TORRES M.D., FACS

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	208600000X	Surgery Physician	17945	PR
2	208C00000X	Colon & Rectal Surgery Physician	17945	PR
3	208C00000X	Colon & Rectal Surgery Physician	ME113662	FL
4	390200000X	Student in an Organized Health Care Education/Training Program	42450	KY

General Provider Information

NPI Number	:	1770762585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA LOREN TORRES - TORRES M.D., FACS

Provider Business Mailing Address
First Line	:	1452 ASHFORD AVENUE
Second Line	:	COND. ADA LIGIA SUITE 1
City	:	SAN JUAN
State	:	PR
Zip	:	00907-5810
Country	:	US
Telephone Number	:	787-724-9595
Fax Number	:	787-724-9494

Provider Business Practice Location Address
First Line	:	1452 ASHFORD AVENUE
Second Line	:	COND. ADA LIGIA SUITE 1
City	:	SAN JUAN
State	:	PR
Zip	:	00907-5810
Country	:	US
Telephone Number	:	787-724-9595
Fax Number	:	787-724-9494

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

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	10/01/2014

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