Provider Demographics
NPI:1013640663
Name:TOLEDANO, VON DENNISE (LICENSE: MA 98737)
Entity Type:Individual
Prefix:
First Name:VON
Middle Name:DENNISE
Last Name:TOLEDANO
Suffix:
Gender:F
Credentials:LICENSE: MA 98737
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10509 SW 216TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1031
Mailing Address - Country:US
Mailing Address - Phone:561-696-1904
Mailing Address - Fax:
Practice Address - Street 1:10509 SW 216TH ST APT A
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1031
Practice Address - Country:US
Practice Address - Phone:561-696-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA98737225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty