1952390189 NPI number — DR. RODRIGO TORRES M.D.

Table of content: DR. RODRIGO TORRES M.D. (NPI 1952390189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952390189 NPI number — DR. RODRIGO TORRES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES
Provider First Name:
RODRIGO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
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:
1952390189
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
708 DEL PRADO BLVD
Provider Second Line Business Mailing Address:
S-9
Provider Business Mailing Address City Name:
CAPE CORAL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33990-5616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-574-2644
Provider Business Mailing Address Fax Number:
239-574-1451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51101-1326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-279-2010
Provider Business Practice Location Address Fax Number:
712-279-2034
Provider Enumeration Date:
10/20/2005

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: 207R00000X , with the licence number:  ME84354 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: MD-44851 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 81757 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00286864 . This is a "RAILROAD PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2736349 00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5789173 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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