Provider Demographics
NPI:1699169722
Name:TORRES-FERNANDEZ, PEDRO
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:TORRES-FERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W BLOOMINGDALE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7405
Mailing Address - Country:US
Mailing Address - Phone:813-610-5112
Mailing Address - Fax:
Practice Address - Street 1:3908 KEARSNEY ABBEY CIR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:FL
Practice Address - Zip Code:33527-6392
Practice Address - Country:US
Practice Address - Phone:813-610-5112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health