Provider Demographics
NPI:1568887453
Name:TORRES, NATHALIE (LMT)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 CORALWOOD CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-8354
Mailing Address - Country:US
Mailing Address - Phone:321-900-5680
Mailing Address - Fax:
Practice Address - Street 1:8803 FUTURES DR STE 4
Practice Address - Street 2:SUITE 202
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9076
Practice Address - Country:US
Practice Address - Phone:407-985-3512
Practice Address - Fax:407-558-4523
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA67261225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist