Healthcare Provider Details

I. General information

NPI: 1710113089
Provider Name (Legal Business Name): NICOLE S TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE M SOSA

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8932 SW 97TH AVE STE D
MIAMI FL
33176-1936
US

IV. Provider business mailing address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-5050
  • Fax: 305-270-3846
Mailing address:
  • Phone: 305-585-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 104043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: