Provider Demographics
NPI:1063463180
Name:LABOY TORRES, JOAQUIN A (MD)
Entity Type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:A
Last Name:LABOY TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801027
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1027
Mailing Address - Country:US
Mailing Address - Phone:787-848-3248
Mailing Address - Fax:
Practice Address - Street 1:URB INDUSTRIAL REPARADA LOTE 2
Practice Address - Street 2:PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732
Practice Address - Country:US
Practice Address - Phone:787-844-5440
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4323207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C78128Medicare UPIN
PR95488Medicare ID - Type Unspecified