Provider Demographics
NPI:1497334098
Name:TORRES, SANDRA ELIZABETH
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SANTAREM CIR
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-4218
Mailing Address - Country:US
Mailing Address - Phone:856-287-2142
Mailing Address - Fax:
Practice Address - Street 1:4161 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9204
Practice Address - Country:US
Practice Address - Phone:941-235-2710
Practice Address - Fax:941-235-2712
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
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