Provider Demographics
NPI:1437268083
Name:MIRANDA TORRES, LUIS ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALEXANDER
Last Name:MIRANDA TORRES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:35 JUAN C BORBON ST 67
Mailing Address - Street 2:PMB 327
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-704-0033
Mailing Address - Fax:787-704-0090
Practice Address - Street 1:201 CALLE GAUTIER BENITEZ
Practice Address - Street 2:CONSOLIDATED MEDICAL PLAZA, STE.305
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-704-0033
Practice Address - Fax:787-704-0090
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12861207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2002469OtherACAA
4288OtherPMC
4012861OtherUIA
90011OtherSSS
M00085OtherMENONITA
7360028OtherHUMANA INSURANCE
PE3801OtherPALIC
7360028OtherHUMANA REFORME
060902OtherCRUZKZUL
600335OtherMMM
7360028OtherHUMANA INSURANCE