Provider Demographics
NPI:1679540611
Name:TORRES FERNANDEZ, TANIA (MD)
Entity Type:Individual
Prefix:DR
First Name:TANIA
Middle Name:
Last Name:TORRES FERNANDEZ
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 1:474 CALLE DE DIEGO APT 1A6
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-3101
Mailing Address - Country:US
Mailing Address - Phone:787-955-5518
Mailing Address - Fax:
Practice Address - Street 1:E6 CALLE MARGINAL
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6708
Practice Address - Country:US
Practice Address - Phone:888-900-0013
Practice Address - Fax:787-289-8715
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15389208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice