Provider Demographics
NPI:1326482811
Name:TORRES VILLAMIL, EDGAR ALFONSO (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:ALFONSO
Last Name:TORRES VILLAMIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDGAR
Other - Middle Name:A
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1065 NE 125TH ST STE 409
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5834
Mailing Address - Country:US
Mailing Address - Phone:888-852-6672
Mailing Address - Fax:305-891-4228
Practice Address - Street 1:1601 N PALM AVENUE
Practice Address - Street 2:SUITE 211
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3204
Practice Address - Country:US
Practice Address - Phone:954-447-0010
Practice Address - Fax:954-447-0899
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012678332084P0800X
FLME1340072084P0800X, 2084P0804X
GA2142084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry