Basic Information
| Provider Information | |||||||||
| NPI: | 1598179491 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORRIJOS | ||||||||
| FirstName: | MARDEN | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 616788 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328616788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4075336836 | ||||||||
| FaxNumber: | 4072329316 | ||||||||
| Practice Location | |||||||||
| Address1: | 8708 GESSNER DRIVE | ||||||||
| Address2: | SUITE K | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770742916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323895272 | ||||||||
| FaxNumber: | 8778833330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2014 | ||||||||
| LastUpdateDate: | 12/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036143771 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 390200000X | 125-065418 | IL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | T1242 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.