Provider Demographics
NPI:1104349794
Name:TORRES, TANYA SAMANTHA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TANYA
Middle Name:SAMANTHA
Last Name:TORRES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5380 STADIUM PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6001
Mailing Address - Country:US
Mailing Address - Phone:321-433-1789
Mailing Address - Fax:321-433-3506
Practice Address - Street 1:5380 STADIUM PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6001
Practice Address - Country:US
Practice Address - Phone:321-433-1789
Practice Address - Fax:321-433-3506
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61120183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist