Healthcare Provider Details

I. General information

NPI: 1942752712
Provider Name (Legal Business Name): OBED TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17892 NW 91ST CT
HIALEAH FL
33018-6541
US

IV. Provider business mailing address

17892 NW 91 CT
HIALEAH FL
33018
US

V. Phone/Fax

Practice location:
  • Phone: 786-394-3719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number227900000X
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: