Provider Demographics
NPI:1700308590
Name:TORRES, MARIAM RIVERON
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:RIVERON
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 SW 196TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8138
Mailing Address - Country:US
Mailing Address - Phone:305-316-3515
Mailing Address - Fax:
Practice Address - Street 1:10900 SW 196TH ST APT 202
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8138
Practice Address - Country:US
Practice Address - Phone:305-316-3515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty