Provider Demographics
NPI:1902901267
Name:TORRES RENTAS, RAFAEL
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:
Last Name:TORRES RENTAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1511
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-1511
Mailing Address - Country:US
Mailing Address - Phone:787-847-0009
Mailing Address - Fax:
Practice Address - Street 1:BO JOBITO
Practice Address - Street 2:KM 0 HM 3
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766
Practice Address - Country:US
Practice Address - Phone:787-847-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 4123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0058340Medicare ID - Type UnspecifiedAMBULANCE LAND