Provider Demographics
NPI:1083615785
Name:TORRES, JANINNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANINNA
Middle Name:M
Last Name:TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANINNA
Other - Middle Name:MERCEDES
Other - Last Name:VILLAVICENCIO ALFARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17325 PAGONIA RD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6008
Mailing Address - Country:US
Mailing Address - Phone:407-905-6014
Mailing Address - Fax:407-654-4113
Practice Address - Street 1:17325 PAGONIA RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6008
Practice Address - Country:US
Practice Address - Phone:407-905-6014
Practice Address - Fax:407-654-4113
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84518208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263851700Medicaid
FL263851700Medicaid
H66050Medicare UPIN
FL263851700Medicaid