Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME132270 | FL |
NPI | 1003825183 |
---|---|
Provider Name | Maria M. Toledo |
First Address | San Juan, PR 00926-5905 |
Second Address | Pensacola, FL 32504-5719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2006 |
Last Update Date | 13/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CT571A | MEDICARE PTAN (01) | PR |