Provider Demographics
NPI:1205966322
Name:TORRES-VEGA, JOSE E (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:E
Last Name:TORRES-VEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CALLE FERROCARRIL, STE. 210
Mailing Address - Street 2:SANTA MARIA MEDICAL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1105
Mailing Address - Country:US
Mailing Address - Phone:787-840-0100
Mailing Address - Fax:787-841-6849
Practice Address - Street 1:SANTA MARIA MEDICAL
Practice Address - Street 2:450 CALLE FERROCARRIL, STE. 210
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1105
Practice Address - Country:US
Practice Address - Phone:787-840-0100
Practice Address - Fax:787-841-6849
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7296207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7296OtherMEDICAL LICENSE
PRC77646Medicare UPIN
PR7296OtherMEDICAL LICENSE