Provider Demographics
NPI:1437112232
Name:TORRES BAEZ, JOSE A (PSYD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:TORRES BAEZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CALLE MATIENZO CINTRON
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00965-5333
Mailing Address - Country:US
Mailing Address - Phone:787-603-4058
Mailing Address - Fax:787-251-4313
Practice Address - Street 1:URB LOMAS VERDES
Practice Address - Street 2:2U5 AVE LAUREL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-251-4313
Practice Address - Fax:787-251-4313
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1871103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q49879Medicare UPIN
PR5-7393Medicare ID - Type Unspecified