Provider Demographics
NPI:1558149146
Name:SALAZAR TOLEDO, MARIA JOSE
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSE
Last Name:SALAZAR TOLEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:JOSE
Other - Last Name:SALAZAR DE ANGULO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8874 NW 115TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1932
Mailing Address - Country:US
Mailing Address - Phone:786-399-5108
Mailing Address - Fax:
Practice Address - Street 1:8874 NW 115TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-1932
Practice Address - Country:US
Practice Address - Phone:786-399-5108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-247019106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician