Provider Demographics
NPI:1083622856
Name:TORO, EDGARDO NICOLAS (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:NICOLAS
Last Name:TORO
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD # MC11-C
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-998-8000
Mailing Address - Fax:813-998-8173
Practice Address - Street 1:13515 TERRACE LAKE LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617
Practice Address - Country:US
Practice Address - Phone:813-998-8000
Practice Address - Fax:813-998-8173
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82212207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261111200Medicaid
H54190Medicare UPIN