Provider Demographics
NPI:1124011580
Name:CANALES TORRES, JOSUE (MD,GP)
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:
Last Name:CANALES TORRES
Suffix:
Gender:M
Credentials:MD,GP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE LAUREL 3 NORTE, AA-24
Mailing Address - Street 2:QUINTAS DE DORADO
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-525-4871
Mailing Address - Fax:
Practice Address - Street 1:88 CALLE FRANCISCO ESCUDE
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-5006
Practice Address - Country:US
Practice Address - Phone:787-796-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR002-2833Medicare ID - Type Unspecified
PRI-25553Medicare UPIN