Provider Demographics
NPI:1477064434
Name:TORRES, LIZ (PTA)
Entity Type:Individual
Prefix:
First Name:LIZ
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:6119 73RD AVE E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-5447
Mailing Address - Country:US
Mailing Address - Phone:941-720-2358
Mailing Address - Fax:941-921-0043
Practice Address - Street 1:2830 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7115
Practice Address - Country:US
Practice Address - Phone:941-927-1234
Practice Address - Fax:941-921-0043
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA24360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty