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General NPI Number Information
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NPI Number | 1396625455
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Entity Type | Organization
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Legal Business Name | ROYAL PALM ORTHOPEDICS SPORTS MEDICINE AND INSTITUTE
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1120 CARLTON AVE STE 1400
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City | LAKE WALES
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State | FL
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Zip | 33853-4347
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Country | US
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Telephone | 863-324-6100
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Fax | 863-324-6111
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Provider Business Mailing Address
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Address Line | 1120 CARLTON AVE STE 1400
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City | LAKE WALES
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State | FL
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Zip | 33853-4347
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Country | US
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Telephone | 863-324-6100
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Fax | 863-324-6111
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Authorized Official
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Title or Position | PHYSICIAN
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Name | BENITO TORRES
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Credential | DO
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Telephone | 863-324-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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