Provider Demographics
NPI:1790562106
Name:TOLES, EUNICE JENNY (LPN, MA)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:JENNY
Last Name:TOLES
Suffix:
Gender:M
Credentials:LPN, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 19TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-5631
Mailing Address - Country:US
Mailing Address - Phone:239-595-9040
Mailing Address - Fax:239-304-9043
Practice Address - Street 1:5319 19TH AVE SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-5631
Practice Address - Country:US
Practice Address - Phone:239-595-9040
Practice Address - Fax:239-304-9043
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5259647164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse