Provider Demographics
NPI:1639166689
Name:CHARLES TORRES, AGNES (MD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:
Last Name:CHARLES TORRES
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 6022
Mailing Address - Street 2:PMB 69
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-6022
Mailing Address - Country:US
Mailing Address - Phone:787-379-6279
Mailing Address - Fax:787-768-2722
Practice Address - Street 1:4NN8 VIA GEORGINA
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-4746
Practice Address - Country:US
Practice Address - Phone:787-379-6279
Practice Address - Fax:787-768-2722
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8858174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE04132Medicare UPIN
PR81474Medicare ID - Type UnspecifiedMEDICARE