Provider Demographics
NPI:1811397375
Name:TORRES, JORGE ALFREDO SR
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ALFREDO
Last Name:TORRES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 CALLE HERMOSILLO
Mailing Address - Street 2:URB VENUS GARDEN
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00926
Mailing Address - Country:UM
Mailing Address - Phone:787-593-3362
Mailing Address - Fax:
Practice Address - Street 1:1674 CALLE HERMOSILLO
Practice Address - Street 2:URB VENUS GARDEN
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00926
Practice Address - Country:UM
Practice Address - Phone:787-593-3362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005169103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist