Provider Demographics
NPI:1417355975
Name:TORRES, MANUEL TORRES
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:TORRES
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 1:500 CARR. 149 SUITE 1
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638
Mailing Address - Country:US
Mailing Address - Phone:787-871-3105
Mailing Address - Fax:787-871-3122
Practice Address - Street 1:500 CARR. 149 KM 9.8
Practice Address - Street 2:EXPRESO CIALES A MANATI
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638
Practice Address - Country:US
Practice Address - Phone:787-871-3105
Practice Address - Fax:787-871-3122
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9834183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician