Provider Demographics
NPI:1205822723
Name:TORO-QUINONES, EDGARDO J (DMD, PHD)
Entity Type:Individual
Prefix:
First Name:EDGARDO
Middle Name:J
Last Name:TORO-QUINONES
Suffix:
Gender:M
Credentials:DMD, PHD
Other - Prefix:
Other - First Name:EDGARDO
Other - Middle Name:J
Other - Last Name:TORO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7657 SW 57TH LN APT 256
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4985
Mailing Address - Country:US
Mailing Address - Phone:787-605-9013
Mailing Address - Fax:
Practice Address - Street 1:2702 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6053
Practice Address - Country:US
Practice Address - Phone:803-365-3021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 184371223X0400X, 1223P0221X
PR27051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics