Provider Demographics
NPI:1689703373
Name:TORRES, ROLANDO (CPO, LPO)
Entity Type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:CPO, LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12711 SW 75TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3475
Mailing Address - Country:US
Mailing Address - Phone:305-553-1217
Mailing Address - Fax:305-553-1237
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 506
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-553-1217
Practice Address - Fax:305-553-1237
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR 75222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4863050001Medicare ID - Type Unspecified