Healthcare Provider Details

I. General information

NPI: 1154316180
Provider Name (Legal Business Name): ROLAND TORRES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13563 NARCOOSSEE RD STE 110
ORLANDO FL
32832-7138
US

IV. Provider business mailing address

13563 NARCOOSSEE RD STE 110
ORLANDO FL
32832-7138
US

V. Phone/Fax

Practice location:
  • Phone: 407-691-6912
  • Fax:
Mailing address:
  • Phone: 407-619-6192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number188337-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME122356
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: