1821093105 NPI number — DR. DIEGO T. TORRES II II M.D.

Table of content: DR. DIEGO T. TORRES II II M.D. (NPI 1821093105)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821093105 NPI number — DR. DIEGO T. TORRES II II M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES II
Provider First Name:
DIEGO
Provider Middle Name:
T.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
II
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821093105
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 CLYDE MORRIS BLVD
Provider Second Line Business Mailing Address:
STE 320
Provider Business Mailing Address City Name:
ORMOND BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32174-8179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-676-2367
Provider Business Mailing Address Fax Number:
386-615-6402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 CLYDE MORRIS BLVD
Provider Second Line Business Practice Location Address:
STE 320
Provider Business Practice Location Address City Name:
ORMOND BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32174-8179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-676-2367
Provider Business Practice Location Address Fax Number:
386-615-6402
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME 79483 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 364530402 . This is a "FLORIDA MEMORIAL HOSPITAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 364530402 . This is a "VOLUSIA HEALTH NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 364530402 . This is a "HUMANA EPO/PPO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: DA2751 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: ME 79483 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P 12014598 . This is a "MULTIPLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00039042 . This is a "MEDICARE RAILROAD IND." identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 53955 . This is a "SOUTH CARE/GEHA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3740307 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 115035 . This is a "FLORIDA HEALTHCARE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 364530402 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 49907 . This is a "BLUE CROSS BLUE SHIELD FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7835270 . This is a "AETNA PPO/POS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2675770 . This is a "AETNA HMO/QPOS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2124011 . This is a "FIRST HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 10D1017164 . This is a "CLIA WAIVED CERT. NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 101460000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com