Healthcare Provider Details

I. General information

NPI: 1649885963
Provider Name (Legal Business Name): EDWARD ALEXANDER TORRES DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 S JOG RD STE 100
DELRAY BEACH FL
33446-3808
US

IV. Provider business mailing address

13550 S JOG RD STE 100
DELRAY BEACH FL
33446-3808
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-5144
  • Fax:
Mailing address:
  • Phone: 561-496-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT36165
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: