Provider Demographics
NPI:1477919231
Name:TORRES, MIOZOTTY (73021)
Entity Type:Individual
Prefix:
First Name:MIOZOTTY
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:73021
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0742
Mailing Address - Country:US
Mailing Address - Phone:787-710-2532
Mailing Address - Fax:787-986-7614
Practice Address - Street 1:CARR 2 KM 156.5 AVE HOSTOS
Practice Address - Street 2:OFFICE PARK 4 EDIFICIO SC. RODE SUITE 349
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1511
Practice Address - Country:US
Practice Address - Phone:787-710-2532
Practice Address - Fax:787-986-7614
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR73021163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR73021OtherNURSE LICENSE