Provider Demographics
NPI:1700869302
Name:TORRES, MARIO ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:ALBERT
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1294 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-877-1887
Mailing Address - Fax:702-877-4536
Practice Address - Street 1:1294 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-877-1887
Practice Address - Fax:702-877-4536
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04730100207RN0300X
PAMD041372E207RN0300X
AZ51360207RN0300X
NV23008207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ103809Medicaid
NJ7530005Medicaid
NJ390004933Medicare PIN
F13096Medicare UPIN
NJ698490AB5Medicare PIN
AZZ185131Medicare PIN