=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326623638
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARISOL ARACELIS TORRES DNP, APRN, PMHNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2021
-----------------------------------------------------
Last Update Date | 12/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28210 PASEO DR STE 190-259
-----------------------------------------------------
City | WESLEY CHAPEL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33543-5392
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-670-7723
-----------------------------------------------------
Fax | 813-336-8927
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 28210 PASEO DR STE 190-259
-----------------------------------------------------
City | WESLEY CHAPEL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33543-5392
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-670-7723
-----------------------------------------------------
Fax | 813-336-8927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11012129
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 11012129
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------