Provider Demographics
NPI:1073502811
Name:NAZARIO-TORRES, NELLY (MD)
Entity Type:Individual
Prefix:
First Name:NELLY
Middle Name:
Last Name:NAZARIO-TORRES
Suffix:
Gender:F
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:CALLE NILO 2427 RIO CANAS
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1716
Mailing Address - Country:US
Mailing Address - Phone:787-432-4402
Mailing Address - Fax:787-432-4402
Practice Address - Street 1:CALLE NILO 2427 RIO CANAS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1716
Practice Address - Country:US
Practice Address - Phone:787-432-4402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15028208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22520NAOtherTRIPLES
PR03539OtherAMERICAN HEALTH
PR100556OtherCRUZ AZUL
PRPG4810OtherPAN AMERICAN LIFE
PR11915028OtherGLOBAL HEALTH
PR7280003OtherHUMANO REFORMA
PR7280003OtherHUMANA HEALTH CHOICE
PR100556OtherCRUZ AZUL
PR11915028OtherGLOBAL HEALTH