Provider Demographics
NPI:1922387182
Name:DE LA TORRE, MONICA (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 SW 117TH AVE STE 314
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4826
Mailing Address - Country:US
Mailing Address - Phone:786-326-9785
Mailing Address - Fax:305-274-5707
Practice Address - Street 1:351 NW LE JEUNE RD STE 308
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5688
Practice Address - Country:US
Practice Address - Phone:305-274-6422
Practice Address - Fax:305-274-5707
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLACN1366207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No104100000XBehavioral Health & Social Service ProvidersSocial Worker