Provider Demographics
NPI:1477138584
Name:TORRES TRAVERSO, LLC
Entity Type:Organization
Organization Name:TORRES TRAVERSO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KEYLA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:TRAVERSO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-375-7771
Mailing Address - Street 1:PO BOX 784
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-0784
Mailing Address - Country:US
Mailing Address - Phone:787-375-7771
Mailing Address - Fax:787-849-1714
Practice Address - Street 1:637 AVE STA TERESA JOURNET
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1300
Practice Address - Country:US
Practice Address - Phone:787-978-7052
Practice Address - Fax:787-849-1715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy