Provider Demographics
NPI:1932118445
Name:DEL TORO, FEDERICO (MD)
Entity Type:Individual
Prefix:
First Name:FEDERICO
Middle Name:
Last Name:DEL TORO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W SAINT MARY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4638
Mailing Address - Country:US
Mailing Address - Phone:337-233-6593
Mailing Address - Fax:337-235-1032
Practice Address - Street 1:300 W SAINT MARY BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4638
Practice Address - Country:US
Practice Address - Phone:337-233-6593
Practice Address - Fax:337-235-1032
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09219R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1957364Medicaid
LA1957364Medicaid
LA5R408Medicare ID - Type Unspecified