Provider Demographics
NPI:1194752311
Name:LUIS E. BASCO TORRES
Entity type:Organization
Organization Name:LUIS E. BASCO TORRES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROPIETARIO
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BASCO TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-857-4539
Mailing Address - Street 1:HC 4 BOX 5847
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794
Mailing Address - Country:US
Mailing Address - Phone:787-857-4539
Mailing Address - Fax:787-857-4539
Practice Address - Street 1:BO QUEBRADA GRANDE SECTOR TRES CAMINOS
Practice Address - Street 2:CARRETERA 152 KM 1.6 INTERIOR
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-4539
Practice Address - Fax:787-857-4539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR57535Medicare ID - Type Unspecified