Provider Demographics
NPI:1861664542
Name:TORRES, JOSE VICENTE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:VICENTE
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:V
Other - Last Name:TORRES RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 11878
Mailing Address - Street 2:CAPARRA HEIGHTS STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1878
Mailing Address - Country:US
Mailing Address - Phone:787-765-0615
Mailing Address - Fax:787-759-7315
Practice Address - Street 1:CALLE MAGA ESQUINA CASIA
Practice Address - Street 2:REPARTO METROPOLITANO
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-765-0615
Practice Address - Fax:787-759-7315
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10153207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology