# ABA FAMILY MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760679088
- **Authorized official:** DR. DIEGO T TORRES II M.D. (MANAGING MEMBER)
- **Authorized official phone:** (386) 676-2367

## Contact information

- **Practice address:** 325 CLYDE MORRIS BLVD, SUITE 320, ORMOND BEACH, FL 32174-8178
- **Practice address phone:** (386) 676-2367
- **Practice address fax:** (386) 615-6402
- **Mailing address:** 325 CLYDE MORRIS BLVD, SUITE 320, ORMOND BEACH, FL 32174-8178
- **Mailing address phone:** (386) 676-2367
- **Mailing address fax:** (386) 615-6402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME79483 | FL | Yes |

## Other

- **Enumeration date:** 10/01/2007
- **Last updated:** 10/01/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DA2451 | MEDICARE RAILROAD | FL |
| 01 | — | K4519 | MEDICARE GROUP NUMBER | FL |
| 01 | — | P00039042 | MEDICARE RAILROAD INDIVID | FL |