1275576803 NPI number — DR. IBEL SORAYA TORRES MD.

Table of content: DR. IBEL SORAYA TORRES MD. (NPI 1275576803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275576803 NPI number — DR. IBEL SORAYA TORRES MD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES
Provider First Name:
IBEL
Provider Middle Name:
SORAYA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275576803
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1311
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GURABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00778-1311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-398-9065
Provider Business Mailing Address Fax Number:
787-737-8142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 183 KM 10.3 EDIF DIAZ BRETANA LOCAL 102
Provider Second Line Business Practice Location Address:
GRUPO SALUD INTEGRAL SAN LORENZO
Provider Business Practice Location Address City Name:
SAN LORENZO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00754-0993
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-736-1515
Provider Business Practice Location Address Fax Number:
787-737-8142
Provider Enumeration Date:
06/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  10241 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 84451 . This is a "SSS PROVIDER NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 061533 . This is a "LA CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7780004 . This is a "HUMANA PROV NUMBER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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