Provider Demographics
NPI:1386868164
Name:TOLEDO PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:TOLEDO PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-309-6323
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0351
Mailing Address - Country:US
Mailing Address - Phone:787-607-6012
Mailing Address - Fax:787-422-2238
Practice Address - Street 1:HC 4 BOX 49500
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-9481
Practice Address - Country:US
Practice Address - Phone:787-607-6012
Practice Address - Fax:787-422-2238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR645152W00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty