Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 34008893T | OH |
Y | 2081P2900X | Pain Medicine | OS10656 | FL |
NPI | 1396928123 |
---|---|
Provider Name | Benito M Torres |
First Address | Lakeland, FL 33813-4902 |
Second Address | Lakeland, FL 33813-4902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2007 |
Last Update Date | 11/11/2020 |