Provider Demographics
NPI:1891757936
Name:TORRES DEL VALLE, MARIELA (MD)
Entity Type:Individual
Prefix:MISS
First Name:MARIELA
Middle Name:
Last Name:TORRES DEL VALLE
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:HC 02 BOX 7681
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9115
Mailing Address - Country:US
Mailing Address - Phone:787-462-6308
Mailing Address - Fax:
Practice Address - Street 1:COND EL CENTRO 2
Practice Address - Street 2:OFIC 33-C AVE MUNOZ RIVERA #500
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-764-9606
Practice Address - Fax:787-756-7990
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14701208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22324Medicare ID - Type Unspecified
I33361Medicare UPIN