Provider Demographics
NPI:1750862124
Name:TOLEDO CASTRO, DIMARYS MERCED (MD)
Entity Type:Individual
Prefix:MISS
First Name:DIMARYS
Middle Name:MERCED
Last Name:TOLEDO CASTRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 E COLONIAL DR STE 1600
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-3937
Mailing Address - Country:US
Mailing Address - Phone:407-895-0801
Mailing Address - Fax:
Practice Address - Street 1:8617 E COLONIAL DR STE 1100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-3919
Practice Address - Country:US
Practice Address - Phone:407-895-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health