Individual
HECTOR ISRAEL DE LA TORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1233 N MAIN ST STE 1A, SAN LUIS, AZ 85336-0663
(928) 550-5514
(928) 722-6113
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 315-7910
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP9715
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224111
—
AZ
Enumeration date
12/08/2016
Last updated
08/19/2024
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