MEDICARE: CARLOS TORRELLAS MD, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	363L00000X	Nurse Practitioner
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
4	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME53116	OTHER	FL	LICENSE

General Provider Information

NPI Number	:	1235941857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOS TORRELLAS MD, LLC

Provider Business Mailing Address
First Line	:	6622 SOUTHPOINT DR S STE 400
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-8093
Country	:	US
Telephone Number	:	904-296-2999
Fax Number	:	904-296-3623

Provider Business Practice Location Address
First Line	:	6622 SOUTHPOINT DR S STE 400
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-8093
Country	:	US
Telephone Number	:	904-296-2999
Fax Number	:	904-296-3623

Authorized Official
Title or Position	:	MD AND OWNER
Name	:	CARLOS TORRELLAS
Credential	:	MD
Telephone Number	:	904-296-2999

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	09/24/2025

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