Healthcare Provider Details

I. General information

NPI: 1669288601
Provider Name (Legal Business Name): ANDRES TORRES PULIDO P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 FOREST HILL BLVD STE 103
WEST PALM BEACH FL
33406-5854
US

IV. Provider business mailing address

172 MIRAMAR AVE
ROYAL PALM BEACH FL
33411-1161
US

V. Phone/Fax

Practice location:
  • Phone: 561-964-4577
  • Fax: 561-964-4572
Mailing address:
  • Phone: 346-520-7694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number3003
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTPPA1228
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3003
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number22-725
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: