Basic Information
| Provider Information | |||||||||
| NPI: | 1245397173 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORRES | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | D'DHIEGO | ||||||||
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| Credential: | D.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1665 BAY RD | ||||||||
| Address2: | APT 223 | ||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331392196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052221892 | ||||||||
| FaxNumber: | 3052221896 | ||||||||
| Practice Location | |||||||||
| Address1: | 10739 W FLAGLER ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331741421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052221892 | ||||||||
| FaxNumber: | 3052221896 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2251X0800X | PT22516 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.