Provider Demographics
NPI:1144620303
Name:TOLEDO, KAISHA JUDIT (MS)
Entity Type:Individual
Prefix:MRS
First Name:KAISHA
Middle Name:JUDIT
Last Name:TOLEDO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8833 DANFORTH DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-9448
Mailing Address - Country:US
Mailing Address - Phone:787-674-8856
Mailing Address - Fax:
Practice Address - Street 1:8833 DANFORTH DR
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-9448
Practice Address - Country:US
Practice Address - Phone:787-674-8856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 101YM0800X
FLRBT-16-18130103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health