Healthcare Provider Details

I. General information

NPI: 1255113379
Provider Name (Legal Business Name): BRANDEN PAUL TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 GRAND BOULEVARD SUITE 206
MIRAMAR BEACH FL
32550-1408
US

IV. Provider business mailing address

7108 S KANNER HWY
STUART FL
34997-7462
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax: 772-675-9100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-303518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: