MEDICARE: DR. KATHERINE BANZON TORRALBA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME149919	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871081893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE BANZON TORRALBA MD

Provider Business Mailing Address
First Line	:	801 MEDICAL CT E
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4623
Country	:	US
Telephone Number	:	352-765-3434
Fax Number	:	352-765-3439

Provider Business Practice Location Address
First Line	:	801 MEDICAL CT E
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4623
Country	:	US
Telephone Number	:	352-765-3434
Fax Number	:	352-765-3439

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2018
Last Update Date	:	09/16/2022

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