Provider Demographics
NPI:1598264392
Name:TORRES, ANGELA PATRICIA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:PATRICIA
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13720 SW 268TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-9112
Mailing Address - Country:US
Mailing Address - Phone:305-479-8015
Mailing Address - Fax:
Practice Address - Street 1:13720 SW 268TH ST APT 105
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-9112
Practice Address - Country:US
Practice Address - Phone:305-479-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020904800Medicaid