Provider Demographics
NPI:1225223985
Name:MARIA C TORRES MD LLC
Entity Type:Organization
Organization Name:MARIA C TORRES MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-264-1052
Mailing Address - Street 1:766 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-4900
Mailing Address - Country:US
Mailing Address - Phone:321-264-1052
Mailing Address - Fax:321-264-0778
Practice Address - Street 1:766 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-4900
Practice Address - Country:US
Practice Address - Phone:321-264-1052
Practice Address - Fax:321-264-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90321261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care