Provider Demographics
NPI:1013285188
Name:TOLEDO, JORGE MIGUEL (DO)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:MIGUEL
Last Name:TOLEDO
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 1:23850 VIA ITALIA CIR APT 1906
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7148
Mailing Address - Country:US
Mailing Address - Phone:239-301-8000
Mailing Address - Fax:239-236-0738
Practice Address - Street 1:23850 VIA ITALIA CIR APT 1906
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:34134-7148
Practice Address - Country:US
Practice Address - Phone:239-301-8000
Practice Address - Fax:239-236-0738
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5907207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS-5907OtherSTATE MEDICAL LICENSE
FL376086300Medicaid