Provider Demographics
NPI:1548620776
Name:TORRES, CHRISTIAN OMAR SR (RN)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:OMAR
Last Name:TORRES
Suffix:SR
Gender:M
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:RES LOS ROSALES
Mailing Address - Street 2:EDIFICIO 11 APARTAMENTO 80
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-2415
Mailing Address - Country:US
Mailing Address - Phone:787-677-5915
Mailing Address - Fax:787-271-0004
Practice Address - Street 1:99 GUILLERMO RIEFKOHL STREET
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00723
Practice Address - Country:UM
Practice Address - Phone:787-839-4320
Practice Address - Fax:787-271-0004
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR72296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR72296OtherRN BSN NURSE