Provider Demographics
NPI:1447363189
Name:TORRES TORRES, ALEXIS S (MD)
Entity type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:S
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:PO BOX 8778
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-8778
Mailing Address - Country:US
Mailing Address - Phone:787-656-2424
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA FONT MARTELS #3
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-656-2424
Practice Address - Fax:787-850-2790
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13728174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020813Medicare ID - Type Unspecified
PRI-21367Medicare UPIN