Provider Demographics
NPI:1053384289
Name:TORRES RODRIGUEZ, EDITH (MD)
Entity type:Individual
Prefix:DR
First Name:EDITH
Middle Name:
Last Name:TORRES RODRIGUEZ
Suffix:
Gender:F
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:PO BOX 722
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0722
Mailing Address - Country:US
Mailing Address - Phone:787-842-6542
Mailing Address - Fax:787-840-0910
Practice Address - Street 1:URB. BELLA VISTA CALLE NUBE
Practice Address - Street 2:#10 BAJOS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-842-6542
Practice Address - Fax:787-840-0910
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10517207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083281Medicare PIN
PRG37208Medicare UPIN