Provider Demographics
NPI:1003632506
Name:TORRES, ISRAEL
Entity type:Individual
Prefix:
First Name:ISRAEL
Middle Name:
Last Name:TORRES
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:CENTRO COMERCIAL PLAZA 66 LOCAL# 8 BO SAN ANTON
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-2419
Mailing Address - Country:US
Mailing Address - Phone:787-220-7842
Mailing Address - Fax:
Practice Address - Street 1:CENTRO COMERCIAL PLAZA 66 LOCAL# 8 BO SAN ANTON
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-220-7842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0830156FX1800X
156FX1900X
PR830156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FX1900XEye and Vision Services ProvidersTechnician/TechnologistOrthoptist