Provider Demographics
NPI:1588246185
Name:LAUREANO TORRES, FAVIOLA NICHOLE
Entity type:Individual
Prefix:
First Name:FAVIOLA
Middle Name:NICHOLE
Last Name:LAUREANO 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 1:645 CALLE TURIN
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3605
Mailing Address - Country:US
Mailing Address - Phone:787-462-8363
Mailing Address - Fax:
Practice Address - Street 1:645 CALLE TURIN
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3605
Practice Address - Country:US
Practice Address - Phone:787-462-8363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program