Provider Demographics
NPI:1093243032
Name:TORRES GUTIERREZ, YANET
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:TORRES GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8328 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3337
Mailing Address - Country:US
Mailing Address - Phone:305-595-2053
Mailing Address - Fax:305-595-0752
Practice Address - Street 1:8328 S W 40TH STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-595-2053
Practice Address - Fax:305-595-0752
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA26150225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant