Provider Demographics
NPI:1134311426
Name:TORROLL, DARLENE (LMT)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:TORROLL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4361 COMANCHE TRAIL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4285
Mailing Address - Country:US
Mailing Address - Phone:904-537-0674
Mailing Address - Fax:
Practice Address - Street 1:305 KINGSLEY LAKE DR
Practice Address - Street 2:SUITE 702
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3043
Practice Address - Country:US
Practice Address - Phone:904-537-0674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 43516174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist