Provider Demographics
NPI:1023115383
Name:TORRES, JOSEPH LOUIS (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LOUIS
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 W BASS ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:407-935-1192
Mailing Address - Fax:407-935-9386
Practice Address - Street 1:309 W BASS ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-935-1192
Practice Address - Fax:407-935-9386
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064738207Q00000X
FLME064738207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373875200Medicaid
23247OtherINDV MEDICARE #
593275101OtherTIN
593275101OtherTIN
E64304Medicare UPIN