Healthcare Provider Details

I. General information

NPI: 1205234630
Provider Name (Legal Business Name): JOAN M DEL TORO TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 METROWEST BLVD STE 103
ORLANDO FL
32835-3290
US

IV. Provider business mailing address

6150 METROWEST BLVD STE 103
ORLANDO FL
32835-3290
US

V. Phone/Fax

Practice location:
  • Phone: 787-557-1079
  • Fax:
Mailing address:
  • Phone: 787-557-1079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: