Provider Demographics
NPI:1639104979
Name:ANNETTE C TOLEDANO MD PA
Entity Type:Organization
Organization Name:ANNETTE C TOLEDANO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:CHANNA
Authorized Official - Last Name:TOLEDANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-895-6808
Mailing Address - Street 1:12550 BISCAYNE BLVD.
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181
Mailing Address - Country:US
Mailing Address - Phone:305-895-6808
Mailing Address - Fax:305-891-7021
Practice Address - Street 1:12550 BISCAYNE BLVD.
Practice Address - Street 2:SUITE 304
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181
Practice Address - Country:US
Practice Address - Phone:305-895-6808
Practice Address - Fax:305-891-7021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL42511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110007451OtherRR MEDICARE
FL110007451OtherRR MEDICARE
D82650Medicare UPIN