Provider Demographics
NPI:1679591887
Name:BAEZ TORRES, LYNETTE M
Entity Type:Individual
Prefix:DR
First Name:LYNETTE
Middle Name:M
Last Name:BAEZ TORRES
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:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-1208
Mailing Address - Country:US
Mailing Address - Phone:787-834-2704
Mailing Address - Fax:787-834-2704
Practice Address - Street 1:HOSP. SAN ANTON IO
Practice Address - Street 2:CALLE POST #18 NORTE
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9555207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83014Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER