Provider Demographics
NPI:1548541949
Name:TORRES, RUBY (LCSW)
Entity type:Individual
Prefix:MS
First Name:RUBY
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20112 SATIN LEAF AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3717
Mailing Address - Country:US
Mailing Address - Phone:917-295-3539
Mailing Address - Fax:813-443-3172
Practice Address - Street 1:2240 TWELVE OAKS WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6970
Practice Address - Country:US
Practice Address - Phone:813-838-4807
Practice Address - Fax:813-333-1236
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08338211041C0700X
FLSW139001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNAMedicaid
FL1548541949Medicare NSC