1093146151 NPI number — MISS JENNIFER TORRES RIVERA SLP

Table of content: MISS JENNIFER TORRES RIVERA SLP (NPI 1093146151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093146151 NPI number — MISS JENNIFER TORRES RIVERA SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES RIVERA
Provider First Name:
JENNIFER
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
SLP
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:
1093146151
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 CALLE TURQUESA
Provider Second Line Business Mailing Address:
VILLA BLANCA
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00725-1939
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47 CALLE TURQUESA
Provider Second Line Business Practice Location Address:
VILLA BLANCA
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-1939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-466-7817
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2013

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: 235Z00000X , with the licence number:  2024 , 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)





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