Healthcare Provider Details

I. General information

NPI: 1073894101
Provider Name (Legal Business Name): MIAMI NEUROSCIENCE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6129 SW 70TH ST
SOUTH MIAMI FL
33143-3451
US

IV. Provider business mailing address

6129 SW 70TH ST
SOUTH MIAMI FL
33143-3451
US

V. Phone/Fax

Practice location:
  • Phone: 786-871-6800
  • Fax: 786-871-6801
Mailing address:
  • Phone: 786-871-6800
  • Fax: 786-871-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS DANIEL TORRES
Title or Position: CEO
Credential:
Phone: 305-284-7595