1124089602 NPI number — DR. LUIS MOISES TORRES SERRANT DPM

Table of content: DR. LUIS MOISES TORRES SERRANT DPM (NPI 1124089602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124089602 NPI number — DR. LUIS MOISES TORRES SERRANT DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES SERRANT
Provider First Name:
LUIS
Provider Middle Name:
MOISES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

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:
1124089602
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
104 CALLE REINA CATALINA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-3274
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-607-7677
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1995 CARR. 2 SUITE 1201
Provider Second Line Business Practice Location Address:
METRO MEDICAL CENTER
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-740-5060
Provider Business Practice Location Address Fax Number:
787-798-3388
Provider Enumeration Date:
04/01/2006

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: 213ES0131X , with the licence number:  043 , 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: 073014 . This is a "CA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660474595 . This is a "MCS CLASSIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60152 . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660474595 . This is a "PMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660474595 . This is a "MAPFRE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660474595 . This is a "CORSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660474595 . This is a "FIRST PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9600131 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 228033 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 48057 . This is a "SSS" identifier . This identifiers is of the category "OTHER".




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