Healthcare Provider Details

I. General information

NPI: 1063712974
Provider Name (Legal Business Name): JASON A. TOLTON APRN-CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 TRAFALGAR CT STE 200E
MAITLAND FL
32751-7420
US

IV. Provider business mailing address

851 TRAFALGAR CT STE 200E
MAITLAND FL
32751-7420
US

V. Phone/Fax

Practice location:
  • Phone: 888-339-8727
  • Fax:
Mailing address:
  • Phone: 407-667-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0020502
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL1-0032184
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9373571
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: