Provider Demographics
NPI:1417239617
Name:TORRES, CARLOS RAFAEL
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:RAFAEL
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CALLE TECA
Mailing Address - Street 2:LOS FLAMBOYANES
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-2761
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 CALLE TECA
Practice Address - Street 2:LOS FLAMBOYANES
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-2761
Practice Address - Country:US
Practice Address - Phone:787-746-6961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3963103TC1900X
PR1046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional