Provider Demographics
NPI:1285707786
Name:TORRES-RUIZ, CECILIO (MD,PA)
Entity type:Individual
Prefix:DR
First Name:CECILIO
Middle Name:
Last Name:TORRES-RUIZ
Suffix:
Gender:M
Credentials:MD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-1962
Mailing Address - Country:US
Mailing Address - Phone:727-861-7043
Mailing Address - Fax:727-861-7382
Practice Address - Street 1:10806 US HIGHWAY 19
Practice Address - Street 2:SUITE 102A
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-2563
Practice Address - Country:US
Practice Address - Phone:727-861-7043
Practice Address - Fax:727-861-7382
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-0068851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379014200Medicaid
FLF96392Medicare UPIN
FL379014200Medicaid