Provider Demographics
NPI:1508998428
Name:TORRES NADAL, BETHZAIDA (MD)
Entity Type:Individual
Prefix:
First Name:BETHZAIDA
Middle Name:
Last Name:TORRES NADAL
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:URB ALTA VISTA M8
Mailing Address - Street 2:CALLE 10
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731
Mailing Address - Country:US
Mailing Address - Phone:787-812-5833
Mailing Address - Fax:787-290-4472
Practice Address - Street 1:PLAZOLETA LAS AMERICAS 2015
Practice Address - Street 2:AVE LAS AMERICAS SUITE 101
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0784
Practice Address - Country:US
Practice Address - Phone:787-842-8945
Practice Address - Fax:787-290-4472
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20569Medicare ID - Type Unspecified