Provider Demographics
NPI:1821093105
Name:TORRES II, DIEGO T II (MD)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:T
Last Name:TORRES II
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:325 CLYDE MORRIS BLVD
Mailing Address - Street 2:STE 320
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8179
Mailing Address - Country:US
Mailing Address - Phone:386-676-2367
Mailing Address - Fax:386-615-6402
Practice Address - Street 1:325 CLYDE MORRIS BLVD
Practice Address - Street 2:STE 320
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8179
Practice Address - Country:US
Practice Address - Phone:386-676-2367
Practice Address - Fax:386-615-6402
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 79483207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL364530402OtherFLORIDA MEMORIAL HOSPITAL
FL364530402OtherVOLUSIA HEALTH NETWORK
FL364530402OtherHUMANA EPO/PPO
FLDA2751OtherMEDICARE RAILROAD
FLME 79483OtherMEDICAL LICENSE
FLP 12014598OtherMULTIPLAN
FLP00039042OtherMEDICARE RAILROAD IND.
FL53955OtherSOUTH CARE/GEHA
FL3740307OtherCIGNA
FL115035OtherFLORIDA HEALTHCARE NUMBER
FL364530402OtherUNITED HEALTHCARE
FL49907OtherBLUE CROSS BLUE SHIELD FL
FL7835270OtherAETNA PPO/POS
FL2675770OtherAETNA HMO/QPOS
FL2124011OtherFIRST HEALTH
FL10D1017164OtherCLIA WAIVED CERT. NUMBER
FL10D1017164OtherCLIA WAIVED CERT. NUMBER
FL2124011OtherFIRST HEALTH
FL7835270OtherAETNA PPO/POS
FLP 12014598OtherMULTIPLAN