MEDICARE: MARIO TORRES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	156323	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053317719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIO TORRES M.D.

Provider Business Mailing Address
First Line	:	19021 VILLAGE BLVD
Second Line	:
City	:	SANDY
State	:	OR
Zip	:	97055-8104
Country	:	US
Telephone Number	:	305-775-8444
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 W 36TH ST FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-6643
Country	:	US
Telephone Number	:	844-947-6782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	07/25/2024

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Directions to “ MARIO TORRES M.D.” Practice Location

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