Provider Demographics
NPI:1366847162
Name:TOSHACH, KATRINA (DVM, DIPLOMATE ACVIM)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:TOSHACH
Suffix:
Gender:F
Credentials:DVM, DIPLOMATE ACVIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-2895
Mailing Address - Country:US
Mailing Address - Phone:904-278-3870
Mailing Address - Fax:
Practice Address - Street 1:304 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-2895
Practice Address - Country:US
Practice Address - Phone:904-278-3870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVM11712174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian