Provider Demographics
NPI:1659977395
Name:TORRES, LUIS DANIEL (OTL)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:DANIEL
Last Name:TORRES
Suffix:
Gender:M
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB JARDINES DE COUNTRY CLUB
Mailing Address - Street 2:CALLE 115 BP 17
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-929-7881
Mailing Address - Fax:
Practice Address - Street 1:URB JARDINES DE COUNTRY CLUB
Practice Address - Street 2:CALLE 115 BP 17
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-929-7881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1283225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist