Individual
JUAN CARLOS DE LA TORRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 N FEDERAL HWY APT 516, HALLANDALE BEACH, FL 33009-3493
(786) 250-7359
Mailing address
401 N FEDERAL HWY APT 516, HALLANDALE BEACH, FL 33009-3493
(786) 250-7359
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CBHCMS100085
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023691900
—
FL
Enumeration date
04/05/2017
Last updated
08/14/2019
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