Provider Demographics
NPI:1508820671
Name:BECK-TORRES, MICHELE RENNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:RENNA
Last Name:BECK-TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 MEDICAL PARK BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3164
Mailing Address - Country:US
Mailing Address - Phone:561-792-4508
Mailing Address - Fax:561-964-8961
Practice Address - Street 1:1447 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3164
Practice Address - Country:US
Practice Address - Phone:561-792-4508
Practice Address - Fax:561-964-8961
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83580174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2700466720000EOtherVISTA
FL0701884OtherUNITED HEALTHCARE
FL270046672OtherTAX ID
FL262844900Medicaid
FL270046672OtherHUMANA
FL195758OtherSTAYWELL/WELLCARE
FLH54674OtherPARITY
FL2702449OtherAETNA
FL62926OtherBCBS
FL270046672OtherHUMANA
FL270046672OtherTAX ID