Healthcare Provider Details

I. General information

NPI: 1205890548
Provider Name (Legal Business Name): MARITZA TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 12 AVE
MIAMI FL
33101-6960
US

IV. Provider business mailing address

1601 NW 12 AVE
MIAMI FL
33101-6960
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-7688
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-243-7688
  • Fax: 305-243-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME62480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: