Provider Demographics
NPI:1568506509
Name:ELA M. TORRES-MOORE, D.M.D. P.A.
Entity Type:Organization
Organization Name:ELA M. TORRES-MOORE, D.M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:TORRES-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:863-669-5046
Mailing Address - Street 1:6702 HAYTER DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3535
Mailing Address - Country:US
Mailing Address - Phone:863-669-5046
Mailing Address - Fax:
Practice Address - Street 1:200 AVENUE K SE STE 4
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4000
Practice Address - Country:US
Practice Address - Phone:863-294-4484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN146731223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty