Provider Demographics
NPI:1306952403
Name:TORRES, JOSE MIGUEL (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MIGUEL
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 848999
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33084
Mailing Address - Country:US
Mailing Address - Phone:954-989-1015
Mailing Address - Fax:954-989-8996
Practice Address - Street 1:2213 UNIVERSITY DRIVE
Practice Address - Street 2:#B
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-989-1015
Practice Address - Fax:954-989-8996
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252166100Medicaid
G62324Medicare UPIN
FL252166100Medicaid