Provider Demographics
NPI:1376858506
Name:FAGES TORRES, JORGE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:E
Last Name:FAGES TORRES
Suffix:
Gender:M
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:CALLE BENITEZ A10
Mailing Address - Street 2:URB. VILLA LISSETTE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-662-2304
Mailing Address - Fax:
Practice Address - Street 1:A10 CALLE BENITEZ
Practice Address - Street 2:URB. VILLA LISSETTE
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3439
Practice Address - Country:US
Practice Address - Phone:787-662-2304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17994208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice