Healthcare Provider Details

I. General information

NPI: 1740493725
Provider Name (Legal Business Name): CECILIO TORRES-RUIZ M.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 PLEASANT HILL RD STE 112
KISSIMMEE FL
34759-3400
US

IV. Provider business mailing address

4545 PLEASANT HILL RD STE 112
KISSIMMEE FL
34759-3400
US

V. Phone/Fax

Practice location:
  • Phone: 407-933-7900
  • Fax: 407-933-8727
Mailing address:
  • Phone: 407-933-7900
  • Fax: 407-933-8727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME-0068851
License Number StateFL

VIII. Authorized Official

Name: DR. CECILIO TORRES-RUIZ
Title or Position: OWNER
Credential: M.D. P.A.
Phone: 407-933-7900