Provider Demographics
NPI:1952051542
Name:TORRES VAZQUEZ, DELVIS OMAR
Entity Type:Individual
Prefix:DR
First Name:DELVIS
Middle Name:OMAR
Last Name:TORRES VAZQUEZ
Suffix:
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 1:1050 AVE LAS PALMAS APT 605
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-5205
Mailing Address - Country:US
Mailing Address - Phone:787-450-5888
Mailing Address - Fax:
Practice Address - Street 1:1050 AVE LAS PALMAS APT 605
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-5205
Practice Address - Country:US
Practice Address - Phone:787-450-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR148-PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant