Provider Demographics
NPI:1275243651
Name:TORO, JONATHAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:TORO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 LAWRY RUN DR APT 406
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3495
Mailing Address - Country:US
Mailing Address - Phone:407-562-6849
Mailing Address - Fax:
Practice Address - Street 1:404 S SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5060
Practice Address - Country:US
Practice Address - Phone:704-291-9267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant