Healthcare Provider Details

I. General information

NPI: 1235941857
Provider Name (Legal Business Name): CARLOS TORRELLAS MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6622 SOUTHPOINT DR S STE 400
JACKSONVILLE FL
32216-8093
US

IV. Provider business mailing address

6622 SOUTHPOINT DR S STE 400
JACKSONVILLE FL
32216-8093
US

V. Phone/Fax

Practice location:
  • Phone: 904-296-2999
  • Fax: 904-296-3623
Mailing address:
  • Phone: 904-296-2999
  • Fax: 904-296-3623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CARLOS TORRELLAS
Title or Position: MD AND OWNER
Credential: MD
Phone: 904-296-2999