Provider Demographics
NPI:1952507048
Name:TORRES, TESSIE M (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TESSIE
Middle Name:M
Last Name:TORRES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1185 WILDWOOD LAKES BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-5813
Mailing Address - Country:US
Mailing Address - Phone:239-961-4082
Mailing Address - Fax:
Practice Address - Street 1:1575 PINE RIDGE RD STE 21
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2111
Practice Address - Country:US
Practice Address - Phone:239-254-0967
Practice Address - Fax:239-566-2957
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 49743246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other