Provider Demographics
NPI:1437236478
Name:TORRES, JOSE GUSTAVO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:GUSTAVO
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2995 DREW ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7496
Mailing Address - Fax:
Practice Address - Street 1:29750 US HIGHWAY 19 N STE 101
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1510
Practice Address - Country:US
Practice Address - Phone:727-786-5058
Practice Address - Fax:813-635-2639
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0043707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010703700Medicaid
FLD57524Medicare UPIN