Provider Demographics
NPI:1659959138
Name:TOLL, ALFREDO LUIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:LUIS
Last Name:TOLL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11750 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3530
Mailing Address - Country:US
Mailing Address - Phone:305-223-3000
Mailing Address - Fax:
Practice Address - Street 1:3134 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4414
Practice Address - Country:US
Practice Address - Phone:773-880-9722
Practice Address - Fax:773-880-9723
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
FL32666207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program