Provider Demographics
NPI:1457912792
Name:TORRES, DANISETTE (MD)
Entity type:Individual
Prefix:
First Name:DANISETTE
Middle Name:
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 1:2100 E SAMPLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7574
Mailing Address - Country:US
Mailing Address - Phone:954-958-7195
Mailing Address - Fax:954-958-7115
Practice Address - Street 1:6405 N FEDERAL HWY STE 404
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1414
Practice Address - Country:US
Practice Address - Phone:954-958-7195
Practice Address - Fax:954-958-7115
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1612112084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology