Provider Demographics
NPI:1912065061
Name:TORRALBA, VICTORIA L (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:TORRALBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 SE 5TH TER
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-4852
Mailing Address - Country:US
Mailing Address - Phone:352-795-7795
Mailing Address - Fax:352-795-5235
Practice Address - Street 1:730 SE 5TH TER
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-4852
Practice Address - Country:US
Practice Address - Phone:352-795-7795
Practice Address - Fax:352-795-5235
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068437207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11011785OtherMCRR
FL27784OtherBCBS
FL378443600Medicaid
FL22784Medicare ID - Type Unspecified
FL27784OtherBCBS