Healthcare Provider Details

I. General information

NPI: 1598112856
Provider Name (Legal Business Name): HEDY ALLYN TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3185 W VINE ST
KISSIMMEE FL
34741-3738
US

IV. Provider business mailing address

6101 BLUE LAGOON DR SUITE 400
MIAMI FL
33126-2055
US

V. Phone/Fax

Practice location:
  • Phone: 407-569-1260
  • Fax: 407-569-1257
Mailing address:
  • Phone: 305-500-2000
  • Fax: 305-500-2182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND6755
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: