Provider Demographics
NPI:1144475237
Name:LATORRE-RODRIGUEZ, AMABEL (LMT)
Entity type:Individual
Prefix:
First Name:AMABEL
Middle Name:
Last Name:LATORRE-RODRIGUEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 W COLUMBUS DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1818
Mailing Address - Country:US
Mailing Address - Phone:813-876-7812
Mailing Address - Fax:813-374-2214
Practice Address - Street 1:3210 W COLUMBUS DR
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1818
Practice Address - Country:US
Practice Address - Phone:813-876-7812
Practice Address - Fax:813-374-2214
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 54842174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist