Basic Information
| Provider Information | |||||||||
| NPI: | 1861071854 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORRES | ||||||||
| FirstName: | LYMAIRIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | SPEECH AND LANGUAGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2684 | ||||||||
| Address2: | |||||||||
| City: | SAN SEBASTIAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006853002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872459815 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | URB. VILLA SERAL | ||||||||
| Address2: | |||||||||
| City: | LARES | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879153000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2021 | ||||||||
| LastUpdateDate: | 04/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | 1613 | PR | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
ID Information
| ID | Type | State | Issuer | Description | 4711475 | 01 | PR | DRIVERS LICENSE | OTHER |