Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 31611 | PR |
Y | 111NI0900X | Internist | 31611 | PR |
NPI | 1003298175 |
---|---|
Provider Name | Juan Pablo Torres |
First Address | Arecibo, PR 00613-0477 |
Second Address | Ponce, PR 00716-4717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 24/06/2015 |