MEDICARE: EDDIE N TORRES M.ED

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	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1386954725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDDIE N TORRES M.ED

Provider Business Mailing Address
First Line	:	241 RUBY AVE
Second Line	:	SUITE 212
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-5627
Country	:	US
Telephone Number	:	321-695-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 RUBY AVE
Second Line	:	SUITE 212
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-5627
Country	:	US
Telephone Number	:	321-695-3800
Fax Number	:

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

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	09/07/2016

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