Provider Demographics
NPI:1316068703
Name:TORRES, DELIANA GONZALEZ (MD)
Entity type:Individual
Prefix:DR
First Name:DELIANA
Middle Name:GONZALEZ
Last Name:TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2804 REMINGTON GREEN CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-1550
Mailing Address - Country:US
Mailing Address - Phone:850-385-4494
Mailing Address - Fax:
Practice Address - Street 1:1328 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:PANACEA
Practice Address - State:FL
Practice Address - Zip Code:32346-2151
Practice Address - Country:US
Practice Address - Phone:850-984-4735
Practice Address - Fax:850-984-4742
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN255208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1-07159Medicare UPIN
002-1213Medicare ID - Type Unspecified