Healthcare Provider Details

I. General information

NPI: 1851906374
Provider Name (Legal Business Name): KASSANDRA TORRES PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11190 HEALTH PARK BLVD
NAPLES FL
34110-5729
US

IV. Provider business mailing address

19570 HIGHLAND OAKS DR APT 206
ESTERO FL
33928-9599
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-1700
  • Fax: 239-624-0311
Mailing address:
  • Phone: 850-598-9794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9113518
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPAT9113518
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: