Provider Demographics
NPI:1174666135
Name:TOBAR, LILLIAM TORRE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAM
Middle Name:TORRE
Last Name:TOBAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 9TH PL
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6136
Mailing Address - Country:US
Mailing Address - Phone:772-778-7217
Mailing Address - Fax:772-978-9898
Practice Address - Street 1:777 37TH ST
Practice Address - Street 2:SUITE C-101
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4873
Practice Address - Country:US
Practice Address - Phone:772-778-7217
Practice Address - Fax:772-778-7220
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5122103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist