Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | ME120168 | FL |
NPI | 1225393556 |
---|---|
Provider Name | Dr. Grace Toledo Padron |
First Address | Miami, FL 33173-3570 |
Second Address | Miami, FL 33136-1013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 12/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
111244100 | (05) | FL |