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Individual

MARIO TORRES-NIEVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(470) 644-1274
Mailing address
5360 ALLATOONA GTWY APT 2206, ACWORTH, GA 30101-7421
(787) 955-5777

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
124739
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN323918
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
124739
CRNA LICENSE NUMBER
IL
Enumeration date
09/13/2022
Last updated
04/18/2025
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