Provider Demographics
NPI:1093743262
Name:TORRES, EMILIO BUENAVENTURA (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:BUENAVENTURA
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1447 MEDICAL PARK BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3164
Mailing Address - Country:US
Mailing Address - Phone:561-204-1449
Mailing Address - Fax:561-204-1461
Practice Address - Street 1:1447 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3164
Practice Address - Country:US
Practice Address - Phone:561-204-1449
Practice Address - Fax:561-204-1461
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME83642207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263131800Medicaid
FLG84241Medicare UPIN
FL263131800Medicaid