Provider Demographics
NPI:1457431603
Name:TOTH, MAGGIE REYES (OD)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:REYES
Last Name:TOTH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:11224 MOONSHINE CREEK CIR.
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:407-963-5973
Mailing Address - Fax:
Practice Address - Street 1:4319 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5217
Practice Address - Country:US
Practice Address - Phone:407-894-4553
Practice Address - Fax:407-228-2260
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3981152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist