Provider Demographics
NPI:1891778312
Name:TOTH, NOLAN C (DO)
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:C
Last Name:TOTH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 W HIGHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4716
Mailing Address - Country:US
Mailing Address - Phone:352-726-8353
Mailing Address - Fax:352-726-5038
Practice Address - Street 1:216 S APOPKA AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4844
Practice Address - Country:US
Practice Address - Phone:352-726-1770
Practice Address - Fax:352-726-5038
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5854208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10749875OtherCAQH
FL77940AOtherMEDICARE GROUP ID
FL57229OtherBCBS OF FL
FL7338625OtherCIGNA
FLCJ7430OtherMEDICARE RR GROUP
FL77940OtherBCBS OF FL GROUP ID
FL269859500OtherMEDICAID GROUP
FL080162753OtherMEDICARE RR
FLOS0005854OtherSTATE LICENSE NUMBER
FL063978800Medicaid
FL77940AOtherMEDICARE GROUP ID
FL77940OtherBCBS OF FL GROUP ID