Healthcare Provider Details

I. General information

NPI: 1144677162
Provider Name (Legal Business Name): CESAR TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W 11TH LN
HIALEAH FL
33012-7761
US

IV. Provider business mailing address

3800 W 11TH LN
HIALEAH FL
33012-7761
US

V. Phone/Fax

Practice location:
  • Phone: 786-315-8119
  • Fax:
Mailing address:
  • Phone: 786-315-8119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: