Organization
ROBERT DE LA TORRE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DE LA TORRE MD (OWNER)
(904) 824-4990
Entity
Organization
Contact information
Practice address
611 ZEAGLER DR, PALATKA, FL 32177-3810
(386) 328-5711
(386) 325-8178
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 824-4990
(904) 824-2226
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME78337
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000UJ
BCBS
FL
05
—
270187100
—
FL
Enumeration date
05/27/2010
Last updated
08/24/2010
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