Provider Demographics
NPI:1073261871
Name:TORRES SANTIAGO, SORANGEL
Entity Type:Individual
Prefix:MISS
First Name:SORANGEL
Middle Name:
Last Name:TORRES SANTIAGO
Suffix:
Gender:F
Credentials:
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 1246
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-1246
Mailing Address - Country:US
Mailing Address - Phone:787-233-0475
Mailing Address - Fax:
Practice Address - Street 1:BO VELAZQUEZ #61
Practice Address - Street 2:CALLE PRINCIPAL EL RIO
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-233-0475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR158761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty