Provider Demographics
NPI:1598179491
Name:TORRIJOS, MARDEN E (MD)
Entity type:Individual
Prefix:DR
First Name:MARDEN
Middle Name:E
Last Name:TORRIJOS
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 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-533-6836
Mailing Address - Fax:407-232-9316
Practice Address - Street 1:8708 GESSNER DRIVE
Practice Address - Street 2:SUITE K
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2916
Practice Address - Country:US
Practice Address - Phone:832-389-5272
Practice Address - Fax:877-883-3330
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143771207Q00000X
IL125-065418390200000X
TXT1242207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program