Provider Demographics
NPI:1093952988
Name:TOLEDO, SANTA M (LPN)
Entity Type:Individual
Prefix:
First Name:SANTA
Middle Name:M
Last Name:TOLEDO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-1744
Mailing Address - Country:US
Mailing Address - Phone:215-831-1598
Mailing Address - Fax:215-831-1598
Practice Address - Street 1:5119 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-1744
Practice Address - Country:US
Practice Address - Phone:215-831-1598
Practice Address - Fax:215-831-1598
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN089111L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse