Provider Demographics
NPI:1881671196
Name:DIAZ-TORRES, ERVING (MD)
Entity Type:Individual
Prefix:
First Name:ERVING
Middle Name:
Last Name:DIAZ-TORRES
Suffix:
Gender:M
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:PO BOX 56011
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-6211
Mailing Address - Country:US
Mailing Address - Phone:787-730-3327
Mailing Address - Fax:
Practice Address - Street 1:AVE MAGNOLIA O-2
Practice Address - Street 2:MAGNOLIA GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-995-4789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15714208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022932Medicare ID - Type Unspecified
PRI-25700Medicare UPIN