Basic Information
| Provider Information | |||||||||
| NPI: | 1164423885 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORRES-NAVEDO | ||||||||
| FirstName: | JULIO | ||||||||
| MiddleName: | DIONISIO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7100 W 20TH AVE | ||||||||
| Address2: | SUITE 608 | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330161897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055574016 | ||||||||
| FaxNumber: | 3058280670 | ||||||||
| Practice Location | |||||||||
| Address1: | 7100 W 20TH AVE | ||||||||
| Address2: | SUITE 608 | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330161897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055574016 | ||||||||
| FaxNumber: | 3058280670 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2005 | ||||||||
| LastUpdateDate: | 11/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | ME35978 | FL | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 069520300 | 05 | FL | MEDICAID |