Provider Demographics
NPI:1982133138
Name:TORRES ALFONSO, ENEIDA (MD)
Entity Type:Individual
Prefix:
First Name:ENEIDA
Middle Name:
Last Name:TORRES ALFONSO
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 1:488 SW 91ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2321
Mailing Address - Country:US
Mailing Address - Phone:786-606-6238
Mailing Address - Fax:
Practice Address - Street 1:8755 SW 24TH ST UNIT A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2070
Practice Address - Country:US
Practice Address - Phone:305-475-9999
Practice Address - Fax:786-530-4072
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN966208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1154378206OtherUNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE