Provider Demographics
NPI:1508925868
Name:TORRES-LOPEZ, WANDA I (MD)
Entity Type:Individual
Prefix:DR
First Name:WANDA
Middle Name:I
Last Name:TORRES-LOPEZ
Suffix:
Gender:F
Credentials:MD
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 3384
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-3384
Mailing Address - Country:US
Mailing Address - Phone:787-878-7272
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:HOSP CALLETANO COLL T TOSTE
Practice Address - Street 2:SUITE 105 CARR 129 AVE SAN LUIS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-7272
Practice Address - Fax:787-848-0318
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12447207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0090351Medicare ID - Type Unspecified