MEDICARE: JOAN M DEL TORO TORRES

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	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1205234630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN M DEL TORO TORRES

Provider Business Mailing Address
First Line	:	6150 METROWEST BLVD STE 103
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3290
Country	:	US
Telephone Number	:	787-557-1079
Fax Number	:

Provider Business Practice Location Address
First Line	:	6150 METROWEST BLVD STE 103
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3290
Country	:	US
Telephone Number	:	787-557-1079
Fax Number	:

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

Provider Enumeration Date	:	12/17/2014
Last Update Date	:	12/17/2014

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