Provider Demographics
NPI:1174681902
Name:TORRES-MENDOZA, RALPH A. (MD)
Entity Type:Individual
Prefix:MR
First Name:RALPH A.
Middle Name:
Last Name:TORRES-MENDOZA
Suffix:
Gender:M
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:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0477
Mailing Address - Country:US
Mailing Address - Phone:787-881-3325
Mailing Address - Fax:
Practice Address - Street 1:AVE. PRINCIPAL #94
Practice Address - Street 2:BAJADERO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00616-0799
Practice Address - Country:US
Practice Address - Phone:787-881-3325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6644208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3200OtherFIRST PLUS
PR4242OtherAMERICAN HEALTH MEDICARE
PR100277OtherMEDICARE Y MUCHO MAS
PR3200OtherINTERNATIONAL MEDICAL CARD
27632OtherTRIPLE-S MEDICARE OPTIMO
PR4754OtherPMC MEDICARE CHOICE
PR2-7632TOOtherTRIPLE SSS
PR39109021OtherCIGNA
PR1174681902OtherAARP
PR4242OtherAMERICAN HEALTH MEDICARE
PR4242OtherAMERICAN HEALTH MEDICARE
PR27632Medicare PIN