Provider Demographics
NPI:1265456404
Name:TORRES, JULIAN A (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:A
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 NW 114TH AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4372
Mailing Address - Country:US
Mailing Address - Phone:305-591-2988
Mailing Address - Fax:305-591-2995
Practice Address - Street 1:4005 NW 114TH AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4372
Practice Address - Country:US
Practice Address - Phone:305-591-2988
Practice Address - Fax:305-591-2995
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI08701Medicare UPIN
FLK5796Medicare ID - Type Unspecified