Provider Demographics
NPI:1205427531
Name:TORRAS MANTRANA, RAIDEL ARMANDO (MD)
Entity type:Individual
Prefix:
First Name:RAIDEL
Middle Name:ARMANDO
Last Name:TORRAS MANTRANA
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 1:9898 SW 88TH ST APT C201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1863
Mailing Address - Country:US
Mailing Address - Phone:786-953-0029
Mailing Address - Fax:
Practice Address - Street 1:114 LAKE IRENE DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2265
Practice Address - Country:US
Practice Address - Phone:786-953-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR022162208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty