Healthcare Provider Details

I. General information

NPI: 1568538718
Provider Name (Legal Business Name): EIJA TOIVONEN WOOD NPRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 LANTANA RD
LAKE WORTH FL
33463-6915
US

IV. Provider business mailing address

300 CROTON AVE APT 302
LANTANA FL
33462-2959
US

V. Phone/Fax

Practice location:
  • Phone: 888-991-4395
  • Fax:
Mailing address:
  • Phone: 561-324-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP3161112
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP3161112
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: