Provider Demographics
NPI:1558925305
Name:TORRES, ANGEL
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:
Last Name:TORRES
Suffix:
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 1:3881 SW 52ND AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6974
Mailing Address - Country:US
Mailing Address - Phone:954-534-1308
Mailing Address - Fax:
Practice Address - Street 1:3881 SW 52ND AVE APT 104
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-6974
Practice Address - Country:US
Practice Address - Phone:954-534-1308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM100325251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management