Provider Demographics
NPI:1770218216
Name:TOLEDANO GUERRA, ANNIA
Entity Type:Individual
Prefix:
First Name:ANNIA
Middle Name:
Last Name:TOLEDANO GUERRA
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 1:5960 S JOG RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6509
Mailing Address - Country:US
Mailing Address - Phone:844-665-4827
Mailing Address - Fax:855-210-2331
Practice Address - Street 1:5960 S JOG RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6509
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:855-210-2331
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF07221198363LF0000X
FLRN9525966363LF0000X
FL11020906363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily