Provider Demographics
NPI:1154302552
Name:BAEZ-TORRES, AXEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:AXEL
Middle Name:A
Last Name:BAEZ-TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:232 ISABEL ST
Mailing Address - Street 2:MANSION REAL
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2620
Mailing Address - Country:US
Mailing Address - Phone:787-840-4260
Mailing Address - Fax:787-840-4260
Practice Address - Street 1:ROAD #2 KM 174.3 INTERIOR BO CAIN ALTO
Practice Address - Street 2:HOSPITAL DE LA CONCEPCION
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:787-892-6465
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11718207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6830048OtherHUMANA
PR20413BAOtherSSS
PR6830048OtherHUMANA