Provider Demographics
NPI:1093874083
Name:TORRES, JOSE RAUL (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:RAUL
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:270 CALLE DEL SOL
Mailing Address - Street 2:2B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-1421
Mailing Address - Country:US
Mailing Address - Phone:787-460-6183
Mailing Address - Fax:787-721-8334
Practice Address - Street 1:10 AVE LAGUNA
Practice Address - Street 2:SUITE 211
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6400
Practice Address - Country:US
Practice Address - Phone:787-791-8897
Practice Address - Fax:787-791-8801
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR107572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRTO20658OtherSSS
PR0020658Medicare ID - Type Unspecified
PRF71677Medicare UPIN