Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ME75408 | FL |
N | 207VX0000X | Obstetrician | ME75408 | FL |
NPI | 1154314482 |
---|---|
Provider Name | Dr. Wanda Torres |
First Address | Trinity, FL 34655-4405 |
Second Address | Trinity, FL 34655-4405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 01/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09816010003 | CIGNA (01) | FL |
254285400 | (05) | FL |
2815265 | AETNA HMO (01) | FL |
43339 | BLUECROSS BLUESHIELD (01) | FL |
7255367 | AETNA PPO (01) | FL |
P11023634 | MULTI PLAN (01) | FL |