Provider Demographics
NPI:1447229240
Name:TORRES, ROSANIE (OD)
Entity type:Individual
Prefix:DR
First Name:ROSANIE
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192443
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2443
Mailing Address - Country:US
Mailing Address - Phone:787-839-3410
Mailing Address - Fax:787-839-3410
Practice Address - Street 1:19 A RIEFKHOL ST
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-839-3410
Practice Address - Fax:787-839-3410
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR399152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR58131Medicare ID - Type Unspecified