Healthcare Provider Details

I. General information

NPI: 1770218216
Provider Name (Legal Business Name): ANNIA TOLEDANO GUERRA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S DIXIE HWY
LAKE WORTH FL
33460-4442
US

IV. Provider business mailing address

421 S DIXIE HWY
LAKE WORTH FL
33460-4442
US

V. Phone/Fax

Practice location:
  • Phone: 561-275-1155
  • Fax: 561-275-1156
Mailing address:
  • Phone: 561-275-1155
  • Fax: 561-275-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11020906
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07221198
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN9525966
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: