Provider Demographics
NPI:1629673652
Name:TORRES, MIGUEL JUAN (RPH)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:JUAN
Last Name:TORRES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10720 SW 72ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2702
Mailing Address - Country:US
Mailing Address - Phone:305-271-9909
Mailing Address - Fax:305-412-1851
Practice Address - Street 1:10720 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2702
Practice Address - Country:US
Practice Address - Phone:305-271-9909
Practice Address - Fax:305-412-1851
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist