Provider Demographics
NPI:1497439665
Name:TORRES, ERNESTO OSVALDO SR
Entity Type:Individual
Prefix:MR
First Name:ERNESTO
Middle Name:OSVALDO
Last Name:TORRES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13718 SW 90TH AVE APT B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-6953
Mailing Address - Country:US
Mailing Address - Phone:786-817-5326
Mailing Address - Fax:
Practice Address - Street 1:13718 SW 90TH AVE APT B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-6953
Practice Address - Country:US
Practice Address - Phone:786-817-5326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025994363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily