Healthcare Provider Details

I. General information

NPI: 1992110985
Provider Name (Legal Business Name): MAYDA TORRES COLON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAYDA TORRES MD

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 03/09/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3978 W HILLSBOROUGH AVE UNIT 21B
TAMPA FL
33614-5628
US

IV. Provider business mailing address

6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US

V. Phone/Fax

Practice location:
  • Phone: 813-906-1412
  • Fax: 813-413-1971
Mailing address:
  • Phone: 786-322-7333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME137520
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: