Provider Demographics
NPI:1033261169
Name:TORRES, ANTONIO (PHD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 74 BOX 6700
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9533
Mailing Address - Country:US
Mailing Address - Phone:787-738-0480
Mailing Address - Fax:
Practice Address - Street 1:HC 74 BOX 6700
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-9533
Practice Address - Country:US
Practice Address - Phone:787-738-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2821103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical