Provider Demographics
NPI:1972178499
Name:TORRES, NEILIS ROSS
Entity Type:Individual
Prefix:
First Name:NEILIS
Middle Name:ROSS
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 COUNTRY WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4628
Mailing Address - Country:US
Mailing Address - Phone:407-744-8081
Mailing Address - Fax:
Practice Address - Street 1:741 COUNTRY WOODS CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4628
Practice Address - Country:US
Practice Address - Phone:407-744-8081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health