Provider Demographics
NPI:1689353542
Name:BUENVIAJE, JOSEPH MARK TOLEDO (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH MARK
Middle Name:TOLEDO
Last Name:BUENVIAJE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LIGHT ST UNIT 1524
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-1431
Mailing Address - Country:US
Mailing Address - Phone:347-965-2503
Mailing Address - Fax:
Practice Address - Street 1:10 LIGHT ST UNIT 1524
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1431
Practice Address - Country:US
Practice Address - Phone:347-965-2503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR259592163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse