Provider Demographics
NPI:1720331341
Name:TORRICO, JAMES ROBERT (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:TORRICO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4790 BARKLEY CIRCLE
Mailing Address - Street 2:BUILDING A
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7593
Mailing Address - Country:US
Mailing Address - Phone:239-275-8882
Mailing Address - Fax:239-275-1969
Practice Address - Street 1:4790 BARKLEY CIRCLE
Practice Address - Street 2:BUILDING A
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7593
Practice Address - Country:US
Practice Address - Phone:239-275-8882
Practice Address - Fax:239-275-1969
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106774363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006717900Medicaid
FLGR749ZMedicare UPIN