Provider Demographics
NPI:1518411024
Name:TORREBLANCA, RENE
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:TORREBLANCA
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 1:8704 NW 35TH ST APT 206
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4328
Mailing Address - Country:US
Mailing Address - Phone:305-922-4703
Mailing Address - Fax:
Practice Address - Street 1:8704 NW 35TH ST APT 206
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4328
Practice Address - Country:US
Practice Address - Phone:305-922-4703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician