Provider Demographics
NPI:1831738483
Name:TORRES PABON, JONATHAN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:TORRES PABON
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BROADWAY SUITE
Mailing Address - Street 2:111
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5863
Mailing Address - Country:US
Mailing Address - Phone:407-502-2520
Mailing Address - Fax:610-638-0835
Practice Address - Street 1:22 BROADWAY STE 111
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5408
Practice Address - Country:US
Practice Address - Phone:407-502-2520
Practice Address - Fax:610-638-0835
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005567363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily