Healthcare Provider Details

I. General information

NPI: 1386558799
Provider Name (Legal Business Name): KATIA P TORRES COSTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 CLAY ST
WINTER PARK FL
32789-5486
US

IV. Provider business mailing address

1235 MOSELLE AVE 24
ORLANDO FL
32807
US

V. Phone/Fax

Practice location:
  • Phone: 407-431-0520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2855803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: