Provider Demographics
NPI:1225267669
Name:TORRES, RAQUEL TANYA (LMT)
Entity Type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:TANYA
Last Name:TORRES
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 1:9914 LIBERTY CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2604
Mailing Address - Country:US
Mailing Address - Phone:352-870-0238
Mailing Address - Fax:
Practice Address - Street 1:9914 LIBERTY CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2604
Practice Address - Country:US
Practice Address - Phone:352-870-0238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019008057225700000X
FLMA50785225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist