Provider Demographics
NPI:1912108804
Name:TORO, ELMER (MD)
Entity Type:Individual
Prefix:DR
First Name:ELMER
Middle Name:
Last Name: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 1:391 LEE BLVD
Mailing Address - Street 2:400
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4973
Mailing Address - Country:US
Mailing Address - Phone:239-369-2226
Mailing Address - Fax:239-369-5820
Practice Address - Street 1:391 LEE BLVD
Practice Address - Street 2:400
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4973
Practice Address - Country:US
Practice Address - Phone:239-369-2226
Practice Address - Fax:239-369-5820
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87058207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266565400Medicaid
FL830349039OtherTAX ID OF OFFICE
FLK4360Medicare ID - Type Unspecified
FL266565400Medicaid