Provider Demographics
NPI:1669430096
Name:TORRES-TORRES, CARLOS MANUEL (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MANUEL
Last Name:TORRES-TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 CALLE 12 NW
Mailing Address - Street 2:PUERTO NUEVO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-2231
Mailing Address - Country:US
Mailing Address - Phone:787-783-4737
Mailing Address - Fax:
Practice Address - Street 1:1304 AVE AMERICO MIRANDA
Practice Address - Street 2:REPARTO METROPOLITANO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2119
Practice Address - Country:US
Practice Address - Phone:787-782-1124
Practice Address - Fax:787-782-1124
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9312208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE93220Medicare UPIN
PR0082537Medicare ID - Type Unspecified