Provider Demographics
NPI:1326189606
Name:TORRES, LOURDES MILDRED (MT)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:MILDRED
Last Name:TORRES
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE SANTA CRUZ
Mailing Address - Street 2:CONDOMINIO RIVER PARK APT O-303
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-8500
Mailing Address - Country:US
Mailing Address - Phone:787-602-6055
Mailing Address - Fax:787-626-4640
Practice Address - Street 1:10 CALLE SANTA CRUZ
Practice Address - Street 2:CONDOMINIO RIVER PARK APT O-303
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-8500
Practice Address - Country:US
Practice Address - Phone:787-602-6055
Practice Address - Fax:787-626-4640
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR5242246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory