Healthcare Provider Details

I. General information

NPI: 1164168845
Provider Name (Legal Business Name): ISRAEL TORRES SOBRINO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10677 N KENDALL DR STE 5-A
MIAMI FL
33176-1510
US

IV. Provider business mailing address

10677 N KENDALL DR # 5A
MIAMI FL
33176-1510
US

V. Phone/Fax

Practice location:
  • Phone: 786-953-7905
  • Fax:
Mailing address:
  • Phone: 786-237-6244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: