Provider Demographics
NPI:1912900093
Name:TORRES ROSARIO, ISMAEL (MD)
Entity type:Individual
Prefix:
First Name:ISMAEL
Middle Name:
Last Name:TORRES ROSARIO
Suffix:
Gender:
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:URB VALLE ESCONDIDO
Mailing Address - Street 2:C-55 CALLE C-3
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-763-1788
Mailing Address - Fax:787-756-7853
Practice Address - Street 1:CALLE APOLO SECTOR SANTA CLARA
Practice Address - Street 2:BO JAYUYA ABAJO
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664
Practice Address - Country:US
Practice Address - Phone:787-828-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2025-05-05
Deactivation Date:2025-04-04
Deactivation Code:
Reactivation Date:2025-04-16
Provider Licenses
StateLicense IDTaxonomies
PR8311207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29906BMedicare ID - Type Unspecified
PRC77715Medicare UPIN