Healthcare Provider Details
I. General information
NPI: 1992974281
Provider Name (Legal Business Name): GILBERT TOLEDO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/21/2008
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7765 SW 87TH AVE 109
MIAMI FL
33173
US
IV. Provider business mailing address
7765 SW 87TH AVE 109
MIAMI FL
33173
US
V. Phone/Fax
- Phone: 305-270-3222
- Fax: 305-270-2607
- Phone: 305-270-3222
- Fax: 305-270-2607
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | DN0012082 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: