Provider Demographics
NPI:1023016540
Name:TOLEDO, JOSE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:TOLEDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 630127
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33163-0127
Mailing Address - Country:US
Mailing Address - Phone:305-672-1256
Mailing Address - Fax:305-672-1266
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 420
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-672-1256
Practice Address - Fax:305-672-1266
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56388208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062702000Medicaid
FL08604ZMedicare ID - Type Unspecified
FL062702000Medicaid