Provider Demographics
NPI:1962624635
Name:RICARDO TORRES-IRIBARREN, M.D.,P.A.
Entity type:Organization
Organization Name:RICARDO TORRES-IRIBARREN, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES-IRIBARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-858-8082
Mailing Address - Street 1:260 CRANDON BLVD
Mailing Address - Street 2:SUITE # 32 PMB 415
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-1536
Mailing Address - Country:US
Mailing Address - Phone:305-858-8082
Mailing Address - Fax:305-858-8020
Practice Address - Street 1:1831 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2419
Practice Address - Country:US
Practice Address - Phone:305-858-8082
Practice Address - Fax:305-858-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2007-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59451261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12404Medicare ID - Type Unspecified
FLE90175Medicare UPIN