Provider Demographics
NPI:1780381582
Name:BOSCAN TOLEDO, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BOSCAN TOLEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 HAMMOCKS BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5504
Mailing Address - Country:US
Mailing Address - Phone:786-572-4010
Mailing Address - Fax:
Practice Address - Street 1:9900 HAMMOCKS BLVD APT 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-5504
Practice Address - Country:US
Practice Address - Phone:786-572-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT23257838106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician