Provider Demographics
NPI:1871202911
Name:ARIAS DE LA TORRE, IDELIS FEDESLINDA
Entity type:Individual
Prefix:
First Name:IDELIS
Middle Name:FEDESLINDA
Last Name:ARIAS DE LA TORRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 VALENCIA PARK DR
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-5496
Mailing Address - Country:US
Mailing Address - Phone:850-291-4584
Mailing Address - Fax:
Practice Address - Street 1:8019 N HIMES AVE STE 311
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2761
Practice Address - Country:US
Practice Address - Phone:813-405-4428
Practice Address - Fax:813-405-4599
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022909363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health