1164417069 NPI number — DANETTE TORRES M.D.

Table of content: DANETTE TORRES M.D. (NPI 1164417069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164417069 NPI number — DANETTE TORRES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TORRES
Provider First Name:
DANETTE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1164417069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
975 BAPTIST WAY
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
HOMESTEAD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33033-7600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-245-4549
Provider Business Mailing Address Fax Number:
305-245-4590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
975 BAPTIST WAY
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33033-7600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-245-4549
Provider Business Practice Location Address Fax Number:
305-245-4590
Provider Enumeration Date:
09/16/2005

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: 208000000X , with the licence number:  ME83861 , 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: 194198 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 29246 . This is a "BLUECROSSBLUESHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 043817319 . This is a "PHCS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 11071 . This is a "DIMENSION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 52761 . This is a "NHP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 043817319 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 043817319 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 043817319 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 04381731921242328544 . This is a "BEECHSTREET" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 043817319 . This is a "TRICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 268255900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 297302 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 4554532 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5666752 . This is a "FIRST HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 178147 . This is a "JMH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: SG078319-H922 . This is a "VISTA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 268255900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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