Provider Demographics
NPI:1689280083
Name:TOLEDO MACHADO, WENDY DEL ROSARIO
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:DEL ROSARIO
Last Name:TOLEDO MACHADO
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 1:7101 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1630
Mailing Address - Country:US
Mailing Address - Phone:813-750-6794
Mailing Address - Fax:
Practice Address - Street 1:7101 GREEN ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1630
Practice Address - Country:US
Practice Address - Phone:813-750-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906958311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home