Provider Demographics
NPI:1659326114
Name:TORNES ACOSTA, ANIBAL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIBAL
Middle Name:
Last Name:TORNES ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 CALLE CUEVAS BUSTAMANTE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2642
Mailing Address - Country:US
Mailing Address - Phone:787-616-4674
Mailing Address - Fax:787-772-9109
Practice Address - Street 1:S CUEVAS BUSTAMANTE 525
Practice Address - Street 2:PARQUE CENTRAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2642
Practice Address - Country:US
Practice Address - Phone:787-614-9285
Practice Address - Fax:787-765-7468
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15268208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022207Medicare PIN