Provider Demographics
NPI:1851385967
Name:TOBON, LUIS F (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:F
Last Name:TOBON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:100 PARK PLACE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-2372
Mailing Address - Country:US
Mailing Address - Phone:407-846-4882
Mailing Address - Fax:407-846-0416
Practice Address - Street 1:100 PARK PLACE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2372
Practice Address - Country:US
Practice Address - Phone:407-846-4882
Practice Address - Fax:407-846-0416
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2011-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0098764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEY524ZMedicare PIN