Provider Demographics
NPI:1336938125
Name:TORRES JR, MAXIMINO
Entity type:Individual
Prefix:MR
First Name:MAXIMINO
Middle Name:
Last Name:TORRES JR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11030 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3742
Mailing Address - Country:US
Mailing Address - Phone:402-919-2073
Mailing Address - Fax:
Practice Address - Street 1:829 N 87TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2709
Practice Address - Country:US
Practice Address - Phone:402-919-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide