Provider Demographics
NPI:1972131662
Name:TORRES CARDONA, OMAR (DC)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:TORRES CARDONA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-1449
Mailing Address - Country:US
Mailing Address - Phone:939-269-6008
Mailing Address - Fax:
Practice Address - Street 1:CARR 100 KM 3.2 INT CARR 311 BO MIRADERO
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:939-269-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR730OtherPUERTO RICO CHIROPRACTIC LICENSE