Provider Demographics
NPI:1255114419
Name:TORRES CARABALLO, JENNIFER (ND)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:TORRES CARABALLO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA NORMA CALLE EMANUEL 270
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-2868
Mailing Address - Country:US
Mailing Address - Phone:787-630-9678
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO SAN VICENTE CALLE CONCORDIA 8169
Practice Address - Street 2:SUITE 106
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-671-1970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR91175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath