Provider Demographics
NPI:1417517285
Name:TOYINBO, GLORIA FUNBI
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:FUNBI
Last Name:TOYINBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11814 AUTUMN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2001
Mailing Address - Country:US
Mailing Address - Phone:727-424-8784
Mailing Address - Fax:
Practice Address - Street 1:11814 AUTUMN CREEK DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-2001
Practice Address - Country:US
Practice Address - Phone:727-424-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002204363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner