Provider Demographics
NPI:1275523755
Name:TORRES, CARLOS PELEGRIN (15971)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:PELEGRIN
Last Name:TORRES
Suffix:
Gender:M
Credentials:15971
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 CALLE SAN JOVINO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4212
Mailing Address - Country:US
Mailing Address - Phone:787-761-7077
Mailing Address - Fax:787-287-0676
Practice Address - Street 1:CALLE SAN JOVINO #419 SAGRADO CORAZON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-761-7077
Practice Address - Fax:787-287-0676
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15971208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice