Provider Demographics
NPI:1205846946
Name:TORRES-POPP, LILIANA JUSTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:LILIANA
Middle Name:JUSTINA
Last Name:TORRES-POPP
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 1:1120 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3702
Mailing Address - Country:US
Mailing Address - Phone:812-282-3060
Mailing Address - Fax:812-288-2418
Practice Address - Street 1:1120 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3702
Practice Address - Country:US
Practice Address - Phone:812-282-3060
Practice Address - Fax:812-288-2418
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035014208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
INO95409Medicare UPIN
IN195790Medicare ID - Type UnspecifiedMEDICARE ID#