Provider Demographics
NPI:1093931545
Name:TORRES-HODGES, DPM, P.A.
Entity Type:Organization
Organization Name:TORRES-HODGES, DPM, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:TORRES-HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:850-478-8633
Mailing Address - Street 1:9400 UNIVERSITY PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5752
Mailing Address - Country:US
Mailing Address - Phone:850-478-8633
Mailing Address - Fax:850-478-8579
Practice Address - Street 1:9400 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5752
Practice Address - Country:US
Practice Address - Phone:850-478-8633
Practice Address - Fax:850-478-8579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2847213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5191220001Medicare NSC
FL1093931545Medicare PIN