Provider Demographics
NPI:1154712982
Name:TORRES CARBONELL, WILLIAM (APRN)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:TORRES CARBONELL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:
Other - Last Name:TORRES CARBONELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:10024 SW 222ND ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1563
Mailing Address - Country:US
Mailing Address - Phone:239-692-2776
Mailing Address - Fax:
Practice Address - Street 1:10024 SW 222ND ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1563
Practice Address - Country:US
Practice Address - Phone:239-692-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009613363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty