Provider Demographics
NPI:1245863539
Name:SCHULTZ-TORRES, JUAN JOSHUA (HIS)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:JOSHUA
Last Name:SCHULTZ-TORRES
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7257 N IRELAND DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-7416
Mailing Address - Country:US
Mailing Address - Phone:352-257-1331
Mailing Address - Fax:
Practice Address - Street 1:3161 E GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3200
Practice Address - Country:US
Practice Address - Phone:352-419-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-15
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5490237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty