Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 036076939 | IL |
NPI | 1003885104 |
---|---|
Provider Name | Adalberto Torres |
First Address | Rockland, DE 19732-0191 |
Second Address | Orlando, FL 32806-2946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 27/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036076939 | (05) | IL |
07215036 | BCBS (01) | IL |
E66597 | (02) | IL |
IL01Y1 | JOHN DEERE (01) | IL |