Basic Information
Provider Information
NPI: 1225655293
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORRES
FirstName: ALAIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7420 NW 70TH AVE
Address2:  
City: PARKLAND
State: FL
PostalCode: 330673965
CountryCode: US
TelephoneNumber: 9548258793
FaxNumber:  
Practice Location
Address1: 8875 HIDDEN RIVER PKWY
Address2:  
City: TAMPA
State: FL
PostalCode: 336371035
CountryCode: US
TelephoneNumber: 8669490108
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2020
LastUpdateDate: 08/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPRN11007778FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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