Provider Demographics
NPI:1386209823
Name:TORRES RODRIGUEZ, ANGEL MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:MANUEL
Last Name:TORRES RODRIGUEZ
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:BO CAMPO ALEGRE
Mailing Address - Street 2:10 CALLE LEO G
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-479-2008
Mailing Address - Fax:
Practice Address - Street 1:BO CAMPO ALEGRE
Practice Address - Street 2:10 CALLE LEO G
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-479-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21373208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice