Provider Demographics
NPI:1013157965
Name:DIAZ TORO, ELBA CECILIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELBA
Middle Name:CECILIA
Last Name:DIAZ TORO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 CALLE MARGINAL VILLAMAR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6345
Mailing Address - Country:US
Mailing Address - Phone:787-630-7397
Mailing Address - Fax:
Practice Address - Street 1:1225 CALLE MARGINAL VILLAMAR
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6345
Practice Address - Country:US
Practice Address - Phone:787-630-7397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22221223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2222OtherPUERTO RICO STATE DENTIST LICENSE