Provider Demographics
NPI:1285633206
Name:TORRES, MARIAN III (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:
Last Name:TORRES
Suffix:III
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIAN
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2320
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-2320
Mailing Address - Country:US
Mailing Address - Phone:787-428-7314
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7581207Q00000X
PR16345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170687101Medicaid
TX170687101Medicaid
TXI17672Medicare UPIN