Provider Demographics
NPI:1316586753
Name:TORRES ANCIANI, JANNETTE
Entity Type:Individual
Prefix:
First Name:JANNETTE
Middle Name:
Last Name:TORRES ANCIANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CALLE BETANCES
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-4464
Mailing Address - Country:US
Mailing Address - Phone:787-983-7916
Mailing Address - Fax:
Practice Address - Street 1:49 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4464
Practice Address - Country:US
Practice Address - Phone:787-858-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1734183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1734OtherCPHT