Healthcare Provider Details

I. General information

NPI: 1194593244
Provider Name (Legal Business Name): ALCIDES MAYMIR TORRENS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12485 SW 137TH AVE STE 106
MIAMI FL
33186-4215
US

IV. Provider business mailing address

11625 SW 168TH TER
MIAMI FL
33157-3955
US

V. Phone/Fax

Practice location:
  • Phone: 305-684-6206
  • Fax:
Mailing address:
  • Phone: 305-684-6206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA1-26-2850671
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: