Provider Demographics
NPI:1619615952
Name:TORRES CABAN, KIMBERLY ANGELIZ
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANGELIZ
Last Name:TORRES CABAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:I4 AVE SAN PATRICIO APT 409
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-3213
Mailing Address - Country:US
Mailing Address - Phone:787-233-0139
Mailing Address - Fax:
Practice Address - Street 1:BAYAMON MEDICAL PLAZA PR-2 KM11.7
Practice Address - Street 2:SUITE 403
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-602-1243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program