Healthcare Provider Details

I. General information

NPI: 1669799607
Provider Name (Legal Business Name): RAYMOND G TOLMOS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10661 SW 88TH ST SUITE 116
MIAMI FL
33176-8709
US

IV. Provider business mailing address

10661 SW 88TH ST SUITE 116
MIAMI FL
33176-8709
US

V. Phone/Fax

Practice location:
  • Phone: 786-353-4325
  • Fax: 305-279-8999
Mailing address:
  • Phone: 786-353-4325
  • Fax: 305-279-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 9773
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberCH9773
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: