Provider Demographics
NPI:1265225197
Name:TORRES DAVILA, EMANUEL D
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:D
Last Name:TORRES DAVILA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 BLUEBIRD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-3115
Mailing Address - Country:US
Mailing Address - Phone:561-229-7805
Mailing Address - Fax:
Practice Address - Street 1:1171 BLUEBIRD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-3115
Practice Address - Country:US
Practice Address - Phone:561-229-7805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-421751106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty