Healthcare Provider Details

I. General information

NPI: 1922562834
Provider Name (Legal Business Name): MONIQUE TORRES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 N MAIN ST
LILLINGTON NC
27546-8286
US

IV. Provider business mailing address

46 TILDEN HOWINGTON DR
LILLINGTON NC
27546-5659
US

V. Phone/Fax

Practice location:
  • Phone: 910-474-0050
  • Fax: 863-228-8484
Mailing address:
  • Phone: 910-494-7856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0010-08851
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: