Provider Demographics
NPI:1275598476
Name:TORRES, OSVALDO AQUILES (MD)
Entity Type:Individual
Prefix:DR
First Name:OSVALDO
Middle Name:AQUILES
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 1:7421 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2977
Mailing Address - Country:US
Mailing Address - Phone:954-724-7410
Mailing Address - Fax:954-724-7412
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:SUITE 206
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2977
Practice Address - Country:US
Practice Address - Phone:954-724-7410
Practice Address - Fax:954-724-7412
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79671207R00000X, 207R00000X
GA41979207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008954800Medicaid
FL2523314OtherAETNA HMP/QPOS
FL35576OtherBC/BS
FL224444OtherCOMPCARE
FLP00248250OtherPALMETO GBA/MCR RAILROAD
FL177021OtherWELLCARE/STAYWELL
FL2510393OtherGHI
FL7814168OtherAETNA PPO/MC/EC
FL35576OtherBC/BS
FL224444OtherCOMPCARE