Provider Demographics
NPI:1992227086
Name:TORRES, LEXIBETH VAZQUEZ (RN)
Entity type:Individual
Prefix:
First Name:LEXIBETH
Middle Name:VAZQUEZ
Last Name:TORRES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 CALLE A
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-1716
Mailing Address - Country:US
Mailing Address - Phone:787-246-8810
Mailing Address - Fax:
Practice Address - Street 1:172 CALLE A
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-1716
Practice Address - Country:US
Practice Address - Phone:787-246-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33465163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR$$$$$$$$$Medicaid