Provider Demographics
NPI:1457419574
Name:TORRES, G. S (DC, FIAMA)
Entity Type:Individual
Prefix:DR
First Name:G.
Middle Name:S
Last Name:TORRES
Suffix:
Gender:M
Credentials:DC, FIAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11805 CARROLLWOOD VILLAGE CV
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-8604
Mailing Address - Country:US
Mailing Address - Phone:813-786-5196
Mailing Address - Fax:813-961-1065
Practice Address - Street 1:11805 CARROLLWOOD VILLAGE CV
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8604
Practice Address - Country:US
Practice Address - Phone:813-786-5196
Practice Address - Fax:813-961-1065
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2629111N00000X
NJ38MC00651300111N00000X
MI2301006555111N00000X
AL1127111N00000X
FLCH 6555111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89718OtherBC BS ID NO.