Provider Demographics
NPI:1396370821
Name:TORRES, MARIA L I (BCABA 0-19-10614)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:L
Last Name:TORRES
Suffix:I
Gender:F
Credentials:BCABA 0-19-10614
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19440 CHRISTMAS RD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8707
Mailing Address - Country:US
Mailing Address - Phone:305-281-7913
Mailing Address - Fax:
Practice Address - Street 1:19440 CHRISTMAS RD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8707
Practice Address - Country:US
Practice Address - Phone:305-281-7913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-19-10614103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020849000Medicaid