Provider Demographics
NPI:1902342595
Name:TORREDA, VINCE (COTA/L)
Entity type:Individual
Prefix:
First Name:VINCE
Middle Name:
Last Name:TORREDA
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 COUNTRY CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2904
Mailing Address - Country:US
Mailing Address - Phone:321-527-0733
Mailing Address - Fax:
Practice Address - Street 1:2475 ALOMA AVE
Practice Address - Street 2:SUITE #214
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792
Practice Address - Country:US
Practice Address - Phone:407-437-2968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15669224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL81064748902OtherFLORIDA HOSPITAL CARE ADVANTAGE