Provider Demographics
NPI:1104455906
Name:VARGAS TORRES, CARMEN
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:VARGAS TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. SABANERA
Mailing Address - Street 2:215 CAMINO DE LA LOMA
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-9481
Mailing Address - Country:US
Mailing Address - Phone:787-464-0236
Mailing Address - Fax:
Practice Address - Street 1:URB. SABANERA
Practice Address - Street 2:215 CAMINO DE LA LOMA
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-9481
Practice Address - Country:US
Practice Address - Phone:787-464-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR135221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical