Provider Demographics
NPI:1346275674
Name:TOLEDANO, ANNETTE CHANNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:CHANNA
Last Name:TOLEDANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 NE 123RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2721
Mailing Address - Country:US
Mailing Address - Phone:305-895-6808
Mailing Address - Fax:305-891-7021
Practice Address - Street 1:1785 NE 123RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2721
Practice Address - Country:US
Practice Address - Phone:305-895-6808
Practice Address - Fax:305-891-7021
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL42511207R00000X
FLME42511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110007481OtherRR MEDICARE
FL96314Medicare ID - Type Unspecified
D82650Medicare UPIN