Provider Demographics
NPI:1427166586
Name:TORRES, FERNANDO (MD)
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name: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 1:351 AVE HOSTOS
Mailing Address - Street 2:MEDICAL EMPORIUM SUITE 104
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-1502
Mailing Address - Country:US
Mailing Address - Phone:787-834-3550
Mailing Address - Fax:787-806-0550
Practice Address - Street 1:351 AVE HOSTOS
Practice Address - Street 2:MEDICAL EMPORIUM SUITE 104
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1502
Practice Address - Country:US
Practice Address - Phone:787-834-3550
Practice Address - Fax:787-806-0550
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6383207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR26729Medicare ID - Type UnspecifiedPROVIDER NUMBER
PRC-7958-3Medicare UPIN