Healthcare Provider Details

I. General information

NPI: 1205427531
Provider Name (Legal Business Name): RAIDEL ARMANDO TORRAS MANTRANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 LAKE IRENE DR
WEST PALM BEACH FL
33411-2265
US

IV. Provider business mailing address

114 LAKE IRENE DR
WEST PALM BEACH FL
33411-2265
US

V. Phone/Fax

Practice location:
  • Phone: 786-953-0029
  • Fax:
Mailing address:
  • Phone: 786-953-0029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number022162
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number22162
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: