Provider Demographics
NPI:1073510400
Name:TORRES, JORGE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:E
Last Name:TORRES
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 1:1132 E NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5350
Mailing Address - Country:US
Mailing Address - Phone:352-365-6650
Mailing Address - Fax:352-365-0932
Practice Address - Street 1:1132 E NORTH BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5350
Practice Address - Country:US
Practice Address - Phone:352-365-6650
Practice Address - Fax:352-365-0932
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0070683207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG28987Medicare UPIN
FL31966Medicare ID - Type Unspecified
FL31966YMedicare PIN