Individual
JAIME TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PA-C
Contact information
Practice address
3030 HARDEN BLVD, LAKELAND, FL 33803-7952
(863) 687-1250
(863) 687-1258
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MANAGED CARE DEPT, LAKELAND, FL 33805-4543
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
25MP00069400
NJ
363AS0400X
Surgical Physician Assistant
Primary
PA9104386
FL
Other
Enumeration date
12/26/2006
Last updated
06/20/2016
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