Provider Demographics
NPI:1326793233
Name:KANAHAN TORRES, MARIA AUXILIADORA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:AUXILIADORA
Last Name:KANAHAN TORRES
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 1:1511 AVE PONCE DE LEON APT 642
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-5049
Mailing Address - Country:US
Mailing Address - Phone:787-685-1375
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL PAVIA ARECIBO
Practice Address - Street 2:CARRETERA 129. KM 1.0 AVE SAN LUIS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-650-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15941I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15941IOtherHEALTH DEPARTMENT - GOVERNMENT OF PUERTO RICO